Individual provider Active NPI

Jacinthe Ventura Malalis, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Sycamore, IL
National Provider Identifier
1811157407
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
036130048 Issued in IL
Practice address
2111 Midlands CT
Sycamore, IL 60178-3125
Phone
(815) 758-0000
Fax
(815) 756-7130
NPI assigned
Jun 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208VP0014X 036130048 IL
Physical Medicine & Rehabilitation Physician 208100000X 036130048 IL Primary

Addresses

Primary practice location

2111 Midlands CT
Sycamore, IL 60178-3125

Mailing address

2111 Midlands CT
Sycamore, IL 60178-3125
Phone (815) 758-0000

Other practice location 1

1310 N Main St Ste 100
Sandwich, IL 60548-1394
Phone (815) 758-0000

Other names 1

  • Dr. Jacinthe Sarthou Ventura Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121012000187 IL Practitioner - Physical Medicine and RehabilitationPractitioner - PsychiatryPractitioner - Pain Management 8527217249 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

2111 Midlands CT
Sycamore, IL 60178-3125
Phone (815) 758-0000

Hospital & facility affiliations

  • Northwestern Medicine Kishwaukee Hospital Hospital, Dekalb, IL, CCN 140286
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Northwestern Medicine Delnor Community Hospital Hospital, Geneva, IL, CCN 140211
  • Rochelle Community Hospital Hospital, Rochelle, IL, CCN 141312

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Oct 1, 2020 Accepting new patients
Central Dupage Physician Group Single Specialty CurrentSince Oct 1, 2020 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

1310 N Main St
Ste 100
Sandwich, IL 60548
Phone (815) 758-0000

1952 Aberdeen Ct
Sycamore, IL 60178
Phone (815) 758-0000

2111 Midlands Ct
Sycamore, IL 60178
Phone (815) 748-8900

2111 Midlands Ct
Ste 100
Sycamore, IL 60178
Phone (815) 758-0000

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1811157407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 MIDLANDS CT",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783125",
            "telephone_number": "815-758-0000",
            "fax_number": "815-756-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 MIDLANDS CT",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783125",
            "telephone_number": "815-758-0000",
            "fax_number": "815-756-7130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1310 N Main St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Sandwich",
            "state": "IL",
            "postal_code": "605481394",
            "country_code": "US",
            "telephone_number": "815-758-0000",
            "fax_number": "815-786-3603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALALIS",
        "first_name": "JACINTHE",
        "middle_name": "VENTURA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-17",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IL",
            "license": "036130048",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036130048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACINTHE",
            "last_name": "VENTURA",
            "middle_name": "SARTHOU",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sycamore, IL

Sources for this page

Verify at the official NPI Registry.