Jessica Katherine Malinowski, PA-C

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

132584 Issued in MN

Practice address

705 Pleasant Ave S
Park Rapids, MN 56470-1440

Phone

(218) 732-2800

NPI assigned

Aug 27, 2019

Last updated

Feb 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology at the Lakes PLLCGroup PAC ID 2860840436, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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

• Dermatology at the Lakes PLLC

  • Dermatology Physician
  • Detroit Lakes, MN
  • NPI 1285416362
  Medicare reassignment Care Compare group
• St Marys Regional Health Center

  dba Essentia Health Park Rapids Hwy 34 Clinic

  • Multi-Specialty Clinic/Center
  • Park Rapids, MN
  • NPI 1730731464
  NPD (past)

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1811545437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 PLEASANT AVE S",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "564701440",
            "telephone_number": "218-732-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALINOWSKI",
        "first_name": "JESSICA",
        "middle_name": "KATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-27",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "132584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicolas Lopez Lara
• Amy Luther, RD, LD
• Katie Luther, MA, LPCC
• Scott Ryan Maanum, M.D.
• Paul Mahling
• Michelle Malkowski
• Audrey Jean Marjama, FNP
• Timothy Arthur Markgraf, LICSW
• Richard Marquardt
• Dancia Rebecca Martens, PA-C

• Dermatology Physician in Park Rapids, MN
• Providers in Park Rapids, MN by specialty
• Dermatology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.