Individual provider Active NPI

Kurt Malkoff, PH.D.

  • Psychologist
  • Columbus, OH
National Provider Identifier
1972697852
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2116 Issued in OH
Practice address
2 Easton Oval
Ste 450
Columbus, OH 43219-6035
Phone
(614) 475-9500
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2116 OH Primary

Addresses

Primary practice location

2 Easton Oval
Ste 450
Columbus, OH 43219-6035

Mailing address

2 Easton Oval
Ste 450
Columbus, OH 43219-6035
Phone (614) 475-9500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150108000197 OH Practitioner - Clinical Psychologist 6608932330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Matrix Integrated Psychological ServicesGroup PAC ID 4880750512, 14 clinicians

Practice addresses (Care Compare)

2 Easton Oval
Suite 450
Columbus, OH 43219-6035
Phone (614) 475-9500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2116OHMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Integrated Psychological Services Psychologist CurrentSince Dec 3, 2008 Accepting new patients

Locations

2 Easton Oval
Ste 450
Columbus, OH 43219
Phone (614) 475-9500

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972697852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 EASTON OVAL",
            "address_2": "STE 450",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432196035",
            "telephone_number": "614-475-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 EASTON OVAL",
            "address_2": "STE 450",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432196035",
            "telephone_number": "614-475-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALKOFF",
        "first_name": "KURT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "2116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.