Look up the most recent NPI and PECOS records

Susan M. Maloney

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

7916 W Jefferson Blvd, Fort Wayne, IN 46804-4140

PECOS Enrollment

This provider is enrolled in PECOS as SUSAN MALONEY.

Based on the most recent information from CMS, provider Susan M. Maloney is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1811276751
Provider Type
Individual
Full Name
Maloney, Susan M.
Credential
NP-C

Gender
Female
Sole Proprietor
No
Enumeration Date
8/10/2011
Last Updated
12/28/2016

Contact Information

Practice Location

7916 W Jefferson Blvd, Fort Wayne, IN 46804-4140

(260) 432-2297

(260) 434-6481

Mailing Location

6920 Pointe Inverness Way Ste 200, Medpartners, Attn: Barb Copeland, Fort Wayne, IN 46804-7934

(260) 479-3514

(260) 479-3520

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 71003728A Indiana

Provider Identifiers

ID	Description	Issuer
ID 201034410	Description Medicaid	Issuer Unlisted Indiana

Susan M. Maloney

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Hillen, Jenna

Jefferies, Erica Marie

Richardson, Kristy J

Hayes, Kalie M.

Becktell, Leia A.

Tippin, Stephanie Ann

Kaiser, Taryn Donnell

Lombard, Paige Marie

Villavicencio, Alex

Degitz, Amber R.