Individual provider Active NPI

Michael Adams Maloney

  • Anesthesiology Physician
  • Walnut Creek, CA
National Provider Identifier
1902169634
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A147856 Issued in CA
Practice address
1601 Ygnacio Valley Rd
Walnut Creek, CA 94598-3122
Phone
(347) 512-3134
NPI assigned
Jun 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Anesthesiology Physician 207LP3000X A147856 CA
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X A147856 CA Primary

Addresses

Primary practice location

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598-3122

Mailing address

PO Box 7096
Stockton, CA 95267-0096
Phone (209) 956-7725

Other practice location 1

450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (718) 270-1000

Other practice location 2

6501 Coyle Ave
Carmichael, CA 95608-0306
Phone (916) 537-5000

Other identifiers 1

IdentifierTypeStateIssuer
1902169634MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20170923000440 CA Practitioner - Anesthesiology 2961783485 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6501 Coyle Ave
Carmichael, CA 95608-0306
Phone (916) 851-2884

Hospital & facility affiliations

  • Mercy San Juan Medical Center Hospital, Carmichael, CA, CCN 050516

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A147856CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shriners Hospitals for Children CurrentSince Jul 1, 2020 Accepting new patients
John Muir Trauma Physicians Billing Service Anesthesiology CurrentSince Sep 27, 2017 Accepting new patients
John Muir Trauma Physicians Billing Service Current Accepting new patients
Shriners Hospitals for Children CurrentSince Jul 1, 2020 Accepting new patients
Dignity Health Past Accepting new patients
Metropolitan Anesthesia Consultants, Inc Anesthesiology Past Accepting new patients
Shriners Hospitals for Children Past Accepting new patients

Locations

2425 Stockton Blvd
Sacramento, CA 95817
Phone (916) 453-2000

1601 Ygnacio Valley Rd
#100
Walnut Creek, CA 94598
Phone (925) 947-5245

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

Organizations & group practices 8

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": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1902169634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7096",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952670096",
            "telephone_number": "209-956-7725",
            "fax_number": "209-956-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 YGNACIO VALLEY RD",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983122",
            "telephone_number": "347-512-3134"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Clarkson Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112032012",
            "country_code": "US",
            "telephone_number": "718-270-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6501 Coyle Ave",
            "address_purpose": "LOCATION",
            "city": "Carmichael",
            "state": "CA",
            "postal_code": "956080306",
            "country_code": "US",
            "telephone_number": "916-537-5000",
            "fax_number": "916-851-2884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALONEY",
        "first_name": "MICHAEL",
        "middle_name": "ADAMS",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-18",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "CA",
            "license": "A147856",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A147856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902169634",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.