Mallory Decesare, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C09151 Issued in MD

Practice address

2401 W Belvedere Ave
Baltimore, MD 21215-5216

Phone

(410) 601-8100

NPI assigned

Sep 12, 2022

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 MD

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifebridge Orthopedic Specialists LLCGroup PAC ID 4082928098, 46 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sinai Hospital of Baltimore Hospital, Baltimore, MD, CCN 210012

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: mdecesare1145216@direct.umm.edu

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.

• Lifebridge Orthopedic Specialists, LLC

  • Neurological Surgery Physician
  • Baltimore, MD
  • NPI 1841696697
  Medicare reassignment Care Compare group

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

• Sinai Hospital of Baltimore, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1285672204
  Care Compare affiliation
• Sinai Hospital of Baltimore, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1487325874
  Care Compare affiliation

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1831811389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216",
            "telephone_number": "410-601-4417",
            "fax_number": "410-601-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216",
            "telephone_number": "410-601-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECESARE",
        "first_name": "MALLORY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-12",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C09151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leatrice Malika Debruhl
• Patrick Debs, MD
• Catherine Debus, LGSW
• Deborah Decamps, D.D.S., M.S.
• Megan Hyle Decapite, M.D.
• Wendy Dechowitz
• Marjorie Ann Deck, LCSW-C
• Abigail Magdalene Decker
• Gabrielle Marie Decker, RN
• Jade Elizabeth Decker

• Physician Assistant in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.