Individual provider Active NPI

Gary Craig Mallis, M.D.

  • Pediatrics Physician
  • Scottsdale, AZ
National Provider Identifier
1811998230
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
22226 Issued in AZ
Practice address
20201 N Scottsdale Healthcare Dr
Suite 270
Scottsdale, AZ 85255-4134
Phone
(480) 585-5355
Fax
(480) 585-5358
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 22226 AZ Primary

Addresses

Primary practice location

20201 N Scottsdale Healthcare Dr
Suite 270
Scottsdale, AZ 85255-4134

Mailing address

20201 N Scottsdale Healthcare Dr
Suite 270
Scottsdale, AZ 85255-4134
Phone (480) 585-5355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20120918000844 AZ Practitioner - Pediatric Medicine 8628226503 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Medical Group CurrentSince Aug 1, 2012 Accepting new patients
Phoenix Children'S Hospital Pediatrics Current Accepting new patients

Locations

5131 E Southern Ave
Mesa, AZ 85206
Phone (480) 833-5437

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

3200 E Camelback Rd
Ste 250
Phoenix, AZ 85018
Phone (602) 933-1814

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1811998230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20201 N SCOTTSDALE HEALTHCARE DR",
            "address_2": "SUITE 270",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852554134",
            "telephone_number": "480-585-5355",
            "fax_number": "480-585-5358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20201 N SCOTTSDALE HEALTHCARE DR",
            "address_2": "SUITE 270",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852554134",
            "telephone_number": "480-585-5355",
            "fax_number": "480-585-5358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLIS",
        "first_name": "GARY",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "22226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.