Active NPI
Troy James Malcom, D.O.
- Urology Physician
- Longmont, CO
National Provider Identifier
1861610925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- DR.0045740
- Practice address
- 1925 Mountain View Ave
Longmont, CO 80501-3128 - Phone
- (720) 718-8305
- Fax
- (303) 485-3377
- NPI assigned
- Apr 23, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | L998183 | MI | |
| Urology Physician | 208800000X | DR.0045740 | CO | Primary |
Addresses
Primary practice location
1925 Mountain View Ave
Longmont, CO 80501-3128
Mailing address
1925 Mountain View Ave
Longmont, CO 80501-3128
Phone (720) 718-8305
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07201222 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Community Hospital of Anaconda
Practice addresses (Care Compare)
305 W Pennsylvania Ave
Anaconda, MT 59711-1900
Phone (406) 563-8571
Hospital & facility affiliations
- Community Hospital of Anaconda
- St James Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L998183 | MI | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Hospital of Anaconda | Current | Accepting new patients | |
| Community Hospital of Anaconda | Current | Accepting new patients | |
| Community Hospital of Anaconda | Current | Accepting new patients | |
| Community Hospital of Anaconda | Current | Accepting new patients |
Locations
401 W Pennsylvania Ave
Anaconda, MT 59711
Phone (406) 563-5261
305 W Pennsylvania Ave
Anaconda, MT 59711
Phone (406) 563-8571
Interoperability endpoints
- tmalcom2051580@wm.providencedirect.org
Organizations & group practices 4
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.
-
- Critical Access Hospital
- Anaconda, MT
- NPI 1205887924
-
- Family Medicine Physician
- Anaconda, MT
- NPI 1538597703
-
- Surgery Physician
- Anaconda, MT
- NPI 1023623675
-
- Family Medicine Physician
- Anaconda, MT
- NPI 1336244797
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Anaconda, MT
- NPI 1205887924
-
- Pediatric Adolescent Medicine Physician
- Anaconda, MT
- NPI 1992838288
Hospital
-
- General Acute Care Hospital
- Butte, MT
- NPI 1528037215
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590105600000",
"number": "1861610925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1925 MOUNTAIN VIEW AVE",
"city": "LONGMONT",
"state": "CO",
"postal_code": "805013128",
"telephone_number": "720-718-8305",
"fax_number": "303-485-3377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1925 MOUNTAIN VIEW AVE",
"city": "LONGMONT",
"state": "CO",
"postal_code": "805013128",
"telephone_number": "720-718-8305",
"fax_number": "303-485-3377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALCOM",
"first_name": "TROY",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-23",
"last_updated": "2020-05-22",
"certification_date": "2020-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "MI",
"license": "L998183",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "CO",
"license": "DR.0045740",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07201222",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Longmont, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2020; 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.