Benjamin Mallicoat, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

01089128A Issued in IN

Practice address

5955 Zeamer Ave
Anchorage, AK 99506-3702

Phone

(937) 208-2007

NPI assigned

Apr 22, 2020

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

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1932729662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 ZEAMER AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995063702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 ZEAMER AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995063702",
            "telephone_number": "937-208-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLICOAT",
        "first_name": "BENJAMIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-22",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01089128A",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hazellyn Malele
• Maletch'S Assisted Living Home
• Fatuesi Maletino
• Hannah Malison
• Miraha Mallari
• Charmine Anjuli Mallipudi
• Brian Patrick Malone, MSPT, ATC
• Rani Malone
• April Maloney
• Samantha Maloney, RD

• Obstetrics & Gynecology Physician in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Obstetrics & Gynecology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.