Individual provider Active NPI

David Mallamaci, MD

  • Family Medicine Physician
  • North Canton, OH
National Provider Identifier
1841249604
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35075103 Issued in OH
Practice address
7072 Mears Gate Dr. NW
North Canton, OH 44720-8850
Phone
(330) 966-1319
Fax
(330) 966-1321
NPI assigned
May 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35075103 OH Primary

Addresses

Primary practice location

7072 Mears Gate Dr. NW
North Canton, OH 44720-8850

Mailing address

7072 Mears Gate Dr. NW
North Canton, OH 44720-8850
Phone (330) 966-1319

Other identifiers 1

IdentifierTypeStateIssuer
2206713MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20120402000110 OH Practitioner - Family Practice 4587824313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jackson Family Practice IncGroup PAC ID 1254344633, 7 clinicians

Practice addresses (Care Compare)

7072 Mears Gate Dr NW
North Canton, OH 44720-8850
Phone 3309661319102

Hospital & facility affiliations

  • Aultman Health Care in Your Home Home health agency, Canton, OH, CCN 367290
  • Mercy Medical Center Home Health & Hospice LLC Home health agency, Canton, OH, CCN 367256
  • Mercy Medical Center Hospital, Canton, OH, CCN 360070
  • Aultman Hospital Hospital, Canton, OH, CCN 360084
  • Akron General Medical Center Hospital, Akron, OH, CCN 360027

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35075103OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Family Practice, Inc. Family Medicine CurrentSince Aug 1, 2000 Accepting new patients

Locations

7072 Mears Gate Dr NW
North Canton, OH 44720
Phone (330) 966-1319

Interoperability endpoints

  • Direct secure messaging: david.mallamaci@jacksonfamilypractice.medentdirect.com

Organizations & group practices 1

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1841249604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7072 MEARS GATE DR. NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447208850",
            "telephone_number": "330-966-1319",
            "fax_number": "330-966-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7072 MEARS GATE DR. NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447208850",
            "telephone_number": "330-966-1319",
            "fax_number": "330-966-1321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLAMACI",
        "first_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35075103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2206713",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Canton, OH

Sources for this page

Verify at the official NPI Registry.