Active NPI
Donna Winderl Malyak, NP
- Family Nurse Practitioner
- North Quincy, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 171752
- 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, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 115481 | Other | MA | FALLON |
| NP2857 | Other | MA | BLUE 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
| License | State | Type | Specialty |
|---|---|---|---|
| 171752 | MA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New 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
- 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.
-
dba Massachusetts General Hospital Outpatient Pharmacy
- General Acute Care Hospital
- Boston, MA
- NPI 1508390014
-
dba Sports Medicine & Wellness in Medway
- Sports Medicine (Family Medicine) Physician
- Medway, MA
- NPI 1508681321
-
- Internal Medicine Physician
- Milford, MA
- NPI 1902856024
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.