NPIMap

Individual provider Active NPI

Paul G Malcharek, MD

  • Internal Medicine Physician
  • Maryville, IL
National Provider Identifier
1891781951
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036093757 Issued in IL
Practice address
2401 S Center St
Maryville, IL 62062-5401
Phone
(618) 344-3046
Fax
(618) 344-5284
NPI assigned
Sep 23, 2005
Last updated
Jan 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036093757 IL Primary

Addresses

Primary practice location

2401 S Center St
Maryville, IL 62062-5401

Mailing address

2401 S Center St
Maryville, IL 62062-5401
Phone (618) 344-3046

Other identifiers 1

IdentifierTypeStateIssuer
036093757MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pmalcharek100356@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040624001142 IL Practitioner - Internal Medicine 4587640263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Illinois Medical College, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
HSHS Medical Group IncGroup PAC ID 5092857821, 212 clinicians

Practice addresses (Care Compare)

2401 S Ctr St
Maryville, IL 62062-5401
Phone (618) 344-3046

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
HSHS Prairie, Inc CurrentSince Sep 7, 2010 Accepting new patients
SJL Health Systems Inc CurrentSince Sep 7, 2010 Accepting new patients
HSHS Prairie, Inc Current Accepting new patients
PC Associates LLC Internal Medicine Past Accepting new patients
HSHS Medical Group Inc Past Accepting new patients

Locations

4500 Memorial Dr
Belleville, IL 62226
Phone (618) 233-7750

1900 E Lake Shore Dr
Ste 330
Decatur, IL 62521
Phone (217) 423-2889

2401 S Center St
Maryville, IL 62062
Phone (618) 344-3046

6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095

1512 N Green Mount Rd
O Fallon, IL 62269
Phone (618) 624-0100

3051 Hollis Dr
Fl 2
Springfield, IL 62704
Phone (217) 321-9321

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
HSHS Hospice IllinoisEffingham, IL, CCN 141658 Hospice W-2 Managing Employee Jan 1, 2026

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1891781951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 S CENTER ST",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625401",
            "telephone_number": "618-344-3046",
            "fax_number": "618-344-5284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S CENTER ST",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625401",
            "telephone_number": "618-344-3046",
            "fax_number": "618-344-5284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALCHAREK",
        "first_name": "PAUL",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036093757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036093757",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pmalcharek100356@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "2401 S Center St",
            "city": "Maryville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620625401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

Verify at the official NPI Registry.