Mallory Louise Dehaes

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11028583 Issued in FL

Practice address

123 Baptist Way
Pensacola, FL 32503-2254

Phone

(850) 434-4011

NPI assigned

Feb 9, 2024

Last updated

Feb 9, 2024By the provider in NPPES

Sex

Female

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 FL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of South Alabama College of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pensacola Lung Group, M.D.'S, P.a.Group PAC ID 7517928062, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gulf Breeze Hospital Hospital, Gulf Breeze, FL, CCN 100266

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Pensacola Lung Group, M.D.'S, P.a.

  • Specialist
  • Pensacola, FL
  • NPI 1619196151
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Health Care, Inc.

  dba Gulf Breeze Hospital

  • General Acute Care Hospital
  • Gulf Breeze, FL
  • NPI 1972664530
  Care Compare affiliation

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

{
    "created_epoch": "1707436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1992569909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8316 MOBILE HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325265217",
            "telephone_number": "850-361-7637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 BAPTIST WAY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032254",
            "telephone_number": "850-434-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHAES",
        "first_name": "MALLORY",
        "middle_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-09",
        "last_updated": "2024-02-09",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11028583",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11028583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph William Defeo, M.D.
• Samuel Defigarelli I, M.D.
• Allen Degges, MD
• Angela Jean Degraaf
• Luke Porter Degraaf
• Mohammadmoein Dehesh, MD
• Brandon Deininger
• John Theodore Dejong, MD
• Aryn Del Valle, PA-C
• Andrea Faye Delacruz, D.O.

• Nurse Practitioner in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.