Individual provider Active NPI

Donna Winderl Malyak, NP

  • Family Nurse Practitioner
  • North Quincy, MA
National Provider Identifier
1851499164
Registry record updated May 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
171752 Issued in MA
Practice address
110 W Squantum St
North Quincy, MA 02171-2122
Phone
(617) 376-3000
Fax
(617) 774-1905
NPI assigned
Sep 20, 2006
Last updated
May 28, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 171752 MA Primary

Addresses

Primary practice location

110 W Squantum St
North Quincy, MA 02171-2122

Mailing address

110 W Squantum St
North Quincy, MA 02171-2122
Phone (617) 376-3000

Other identifiers 2

IdentifierTypeStateIssuer
115481OtherMAFALLON
NP2857OtherMABLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
171752MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
General Hospital Corp Current Accepting new patients
Milford Regional Physician Group, Inc. Past Accepting new patients
Milford Regional Physician Group, Inc. Past Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

Interoperability endpoints

  • Direct secure messaging: winderl-malyak.donna.mgh@direct.partners.masshiway.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432771200000",
    "number": "1851499164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W SQUANTUM ST",
            "city": "NORTH QUINCY",
            "state": "MA",
            "postal_code": "021712122",
            "telephone_number": "617-376-3000",
            "fax_number": "617-774-1905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W SQUANTUM ST",
            "city": "NORTH QUINCY",
            "state": "MA",
            "postal_code": "021712122",
            "telephone_number": "617-376-3000",
            "fax_number": "617-774-1905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINDERL MALYAK",
        "first_name": "DONNA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2015-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "171752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "115481",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "NP2857",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Quincy, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.