Charles D Malis, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

58602 Issued in MA

Practice address

107 Commercial St
Mashpee, MA 02649

Phone

(508) 477-7090

Fax

(508) 477-3090

NPI assigned

Jan 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Hahnemann University College of Medicine, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

VK New England Management LLCGroup PAC ID 7810134640, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Merrimack Health Lawrence Hospital Hospital, Lawrence, MA, CCN 220010

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• VK New England Management LLC

  • Primary Care Clinic/Center
  • Lawrence, MA
  • NPI 1114263449
  Medicare reassignment Care Compare group
• Health Quality Inc.

  • Health Service Clinic/Center
  • North Andover, MA
  • NPI 1306384672
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lawrence General Hospital

  • General Acute Care Hospital
  • Lawrence, MA
  • NPI 1750381281
  Care Compare affiliation

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1891766176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 WINTHROP ST",
            "address_2": "UNIT 1 THE CONCORD CLINIC",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422076",
            "telephone_number": "978-369-2266",
            "fax_number": "978-369-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 COMMERCIAL ST",
            "city": "MASHPEE",
            "state": "MA",
            "postal_code": "02649",
            "telephone_number": "508-477-7090",
            "fax_number": "508-477-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIS",
        "first_name": "CHARLES",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "58602",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "58602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3024741",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Lucca, LICSW
• Heather Macara, LCSW
• Miriam C Mackenzie, M.ED
• Lee Macleod
• Kyle Riley Mahoney, PT
• Sarah Maloney
• John Francis Mancini, DDS
• Beth A Manhardt, LICSW
• Jessie M Maniscalco, PT
• Lewis Mantel, M.D.

• Family Medicine Physician in Mashpee, MA
• Providers in Mashpee, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; 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.

Verify at the official NPI Registry.