Individual provider Active NPI

Jennifer D Malek, CNS,BC

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Moraine, OH
National Provider Identifier
1861659039
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
APRN.CNS.01078 Issued in OH
Practice address
5350 Lamme Rd
Moraine, OH 45439-3215
Phone
(937) 534-4651
Fax
(937) 534-4669
NPI assigned
May 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X NS01078 OH
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X APRN.CNS.01078 OH Primary

Addresses

Primary practice location

5350 Lamme Rd
Moraine, OH 45439-3215

Mailing address

3535 Pentagon Blvd Ste 230
Beavercreek, OH 45431-1705
Phone (855) 500-2873

Other identifiers 1

IdentifierTypeStateIssuer
0052850MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jmalek11745@direct.ketteringhealth.org
FHIR URL https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110922000508 OH Practitioner - Certified Clinical Nurse Specialist (CNS) 0042481095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

3700 Southern Blvd
Kettering, OH 45429-1265

4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309

4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751

600 W Main St
Troy, OH 45373-3384

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
63.67
Promoting interoperability
100
Improvement activities
40
Cost
74.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NS01078OHMDClinical Nurse Specialist
APRN.CNS.01078OHMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc CurrentSince Dec 29, 2022 Accepting new patients

Locations

3535 Pentagon Blvd
Ste 230
Beavercreek, OH 45431
Phone (855) 500-2873

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

3700 Southern Blvd
Ste 401
Kettering, OH 45429
Phone (855) 500-2873

3533 Southern Blvd
Ste 5200
Kettering, OH 45429
Phone (937) 395-8002

2110 Leiter Rd
Miamisburg, OH 45342
Phone (937) 384-4838

2115 Leiter Rd
Miamisburg, OH 45342
Phone (937) 384-6920

5350 Lamme Rd
Moraine, OH 45439
Phone (937) 534-4632

5348 Lamme Rd
Moraine, OH 45439
Phone (937) 534-4651

600 W Main St
Ste 130
Troy, OH 45373
Phone (855) 500-2873

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 1

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": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1861659039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 PENTAGON BLVD STE 230",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454311705",
            "telephone_number": "855-500-2873",
            "fax_number": "937-281-3913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 LAMME RD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454393215",
            "telephone_number": "937-534-4651",
            "fax_number": "937-534-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALEK",
        "first_name": "JENNIFER",
        "middle_name": "D",
        "credential": "CNS,BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-16",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "OH",
            "license": "NS01078",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "OH",
            "license": "APRN.CNS.01078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0052850",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmalek11745@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3535 Pentagon Blvd Ste 230",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454311705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "3535 Pentagon Blvd Ste 230",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454311705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Moraine, OH

Sources for this page

Verify at the official NPI Registry.