Baird Mallory, MD

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

016846 Issued in ME

Practice address

887 Congress St
Suite 300
Portland, ME 04102

Phone

(207) 662-5555

Fax

(207) 662-5526

NPI assigned

Jun 13, 2005

Last updated

Jan 5, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Baird M Smith Former name

Medicare fee-for-service enrollment

Enrolled in ME

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bmallory946@direct.mmc.mainehealth.org

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.

• Maine Medical Partners

  dba Maine Medical Partners Pediatrics

  • Pediatrics Physician
  • Saco, ME
  • NPI 1134144090
  Medicare reassignment NPD
• Mainehealth

  dba Mainehealth Behavioral Health

  • Psychiatric Hospital
  • Westbrook, ME
  • NPI 1790265502
  Medicare reassignment NPD
• Maine Medical Partners

  dba Maine Medical Partners Pediatric Surgery

  • Pediatric Surgery Physician
  • Portland, ME
  • NPI 1134305386
  NPD
• Maine Medical Partners

  • Surgery Physician
  • Scarborough, ME
  • NPI 1346687167
  NPD
• Mainehealth

  dba MaineHealth Pharmacy Brighton Ave

  • Community/Retail Pharmacy
  • Portland, ME
  • NPI 1013868181
  NPD
• Mainehealth

  dba MaineHealth Maine Medical Center

  • General Acute Care Hospital
  • Portland, ME
  • NPI 1760436216
  NPD
• Mainehealth

  dba MaineHealth Medical Group-Primary Care

  • Clinic/Center
  • Portland, ME
  • NPI 1487346722
  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1942204466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 US ROUTE 1",
            "address_2": "BUILDING C",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747609",
            "telephone_number": "207-396-8600",
            "fax_number": "207-396-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "887 CONGRESS ST",
            "address_2": "SUITE 300",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04102",
            "telephone_number": "207-662-5555",
            "fax_number": "207-662-5526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLORY",
        "first_name": "BAIRD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "ME",
            "license": "016846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431803499",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BAIRD",
            "last_name": "SMITH",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kimberly Taylor Malka, M.D.
• Brian Edward Malley, MD
• Carin King Malley, MD
• Tehshina Mallick
• Charles J. Mallo, DO
• Leah A Mallory, MD
• Cheyenne Malloy
• Ashley Malmberg
• Richard Christopher Malo, CRNA
• Samantha Malone, PA-C

• Pediatric Surgery Physician in Portland, ME
• Providers in Portland, ME by specialty
• Pediatric Surgery Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; 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.