NPIMap

Individual provider Active NPI

Michael D Maloney, MD

  • Diagnostic Radiology Physician
  • Yreka, CA
National Provider Identifier
1992787238
Registry record updated Jan 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G46471 Issued in CA
Practice address
444 Bruce St
Yreka, CA 96097-3450
Phone
(530) 842-4121
Fax
(530) 842-9054
NPI assigned
Nov 14, 2005
Last updated
Jan 12, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G46471 CA Primary

Addresses

Primary practice location

444 Bruce St
Yreka, CA 96097-3450

Mailing address

PO Box 1105
Yreka, CA 96097-1105
Phone (530) 842-4121

Other identifiers 1

IdentifierTypeStateIssuer
GR0041660MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080514000246 CA Practitioner - Diagnostic Radiology 6103995303 Reassigns benefits to 1 organization
Receives reassigned benefits from 4 practitioners
Practice locations: Yreka, CA

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Loma Linda University School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Shasta Radiology IncGroup PAC ID 2062424583, 5 clinicians

Practice addresses (Care Compare)

1111 N Nagle St
Alturas, CA 96101-3840
Phone (530) 708-8800

444 Bruce St
Yreka, CA 96097-3450
Phone (530) 841-6222

914 Pine St
Mount Shasta, CA 96067-2143
Phone (530) 926-6111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
14.64 of 100Reported as individual
Quality
20
Improvement activities
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G46471CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Shasta Radiology Inc Diagnostic Radiology CurrentSince Jul 1, 2017 Accepting new patients

Locations

1111 N Nagle St
Alturas, CA 96101
Phone (530) 708-8800

914 Pine St
Mount Shasta, CA 96067
Phone (503) 926-6111

543 N Main St
Yreka, CA 96097
Phone (530) 842-7297

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231718400000",
    "number": "1992787238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1105",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960971105",
            "telephone_number": "530-842-4121",
            "fax_number": "530-842-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 BRUCE ST",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973450",
            "telephone_number": "530-842-4121",
            "fax_number": "530-842-9054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONEY",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2009-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G46471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0041660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yreka, CA

Sources for this page

Verify at the official NPI Registry.