Active NPI
Karen Malcomson, NPP
- Nurse Practitioner
- Mattituck, NY
National Provider Identifier
1891879136
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Jun 20, 2019.
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- F400251
- Practice address
- 7555 Main Road
Mattituck, NY 11952 - Phone
- (631) 298-8642
- Fax
- (631) 298-4869
- NPI assigned
- Oct 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | F400251 | NY | Primary |
Addresses
Primary practice location
7555 Main Road
Mattituck, NY 11952
Mailing address
790 Park Ave
Huntington, NY 11743-4516
Phone (631) 427-3700
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F400251 | NY | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405296000000",
"number": "1891879136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 PARK AVE",
"city": "HUNTINGTON",
"state": "NY",
"postal_code": "117434516",
"telephone_number": "631-427-3700",
"fax_number": "631-427-0287"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7555 MAIN ROAD",
"city": "MATTITUCK",
"state": "NY",
"postal_code": "11952",
"telephone_number": "631-298-8642",
"fax_number": "631-298-4869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALCOMSON",
"first_name": "KAREN",
"credential": "NPP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-24",
"last_updated": "2014-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NY",
"license": "F400251",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mattituck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.