Individual provider Active NPI

Kristin Ann Mallon, CNM

  • Midwife
  • New York, NY
National Provider Identifier
1861568602
Registry record updated Aug 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
F001235 Issued in NY
Practice address
130 7TH Ave S
New York, NY 10014-3132
Phone
(917) 938-7745
Fax
(855) 449-7548
NPI assigned
Nov 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X F001235 NY Primary
Midwife 176B00000X 25ME00050300 NJ

Addresses

Primary practice location

130 7TH Ave S
New York, NY 10014-3132

Mailing address

358 Beech St
Hackensack, NJ 07601-1344
Phone (718) 612-5077

Other practice location 1

358 Beech St
Hackensack, NJ 07601-1344
Phone (201) 487-8600

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)
Not enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
25ME00050300NJMDMidwife
F001235NYMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Maternal Resources PC Past Accepting new patients
Materna New York Medicine PC PastSince May 25, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kristin.mallon.1@7791.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/7791/brand/4/csg/1/fhir/r4

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": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787443200000",
    "number": "1861568602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "358 BEECH ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011344",
            "telephone_number": "718-612-5077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 7TH AVE S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100143132",
            "telephone_number": "917-938-7745",
            "fax_number": "855-449-7548"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "358 Beech St",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076011344",
            "country_code": "US",
            "telephone_number": "201-487-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLON",
        "first_name": "KRISTIN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-24",
        "last_updated": "2026-08-23",
        "certification_date": "2026-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "NY",
            "license": "F001235",
            "primary": true
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "NJ",
            "license": "25ME00050300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2026; 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.