Individual provider Active NPI

Malcolm O Perry III, M.D.

  • Urology Physician
  • Allen, TX
National Provider Identifier
1922111541
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
J1476 Issued in TX
Practice address
950 W Bethany Dr Ste 360
Allen, TX 75013-3837
Phone
(469) 854-6116
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X J1476 TX Primary

Addresses

Primary practice location

950 W Bethany Dr Ste 360
Allen, TX 75013-3837

Mailing address

950 W Bethany Dr Ste 360
Allen, TX 75013-3837
Phone (469) 854-6116

Other identifiers 1

IdentifierTypeStateIssuer
035007601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20090309000679 TX Practitioner - Urology 2163588591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
JS Weill Medical College, Cornell University, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1111 Raintree Cir
Suite 240
Allen, TX 75013-4902
Phone (469) 854-6116

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Malcolm O Perry III MD PA Urology CurrentSince Dec 24, 2008 Accepting new patients

Locations

950 W Bethany Dr
Ste 360
Allen, TX 75013
Phone (469) 854-6116

1111 Raintree Cir
Ste 240
Allen, TX 75013
Phone (214) 644-0280

1101 Raintree Cir
Ste 230
Allen, TX 75013
Phone (469) 854-6116

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.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1922111541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 W BETHANY DR STE 360",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750133837",
            "telephone_number": "469-854-6116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 W BETHANY DR STE 360",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750133837",
            "telephone_number": "469-854-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "MALCOLM",
        "middle_name": "O",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "J1476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035007601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen, TX

Sources for this page

Verify at the official NPI Registry.