MICHAEL L MALONE MD
NPI 1053469536
Internal Medicine - Geriatric Medicine in Milwaukee, WI

NPI Status: Active since January 08, 2007

Contact Information

1020 N 12TH ST
3RD FLOOR
MILWAUKEE, WI
ZIP 53233
Phone: (414) 219-7300

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  • Individual
  • Male
  • Internal Medicine
  • Geriatric Medicine
  • Accepts Insurance
  • PECOS Enrolled

About MICHAEL MALONE

This page provides the complete NPI Profile along with additional information for Michael Malone, an internist established in Milwaukee, Wisconsin with a medical specialization in Internal Medicine, focusing in geriatric medicine . The healthcare provider is registered in the NPI registry with number 1053469536 assigned on January 2007. The practitioner's primary taxonomy code is 207RG0300X with license number 26583-020 (WI). The provider is registered as an individual and his NPI record was last updated 5 years ago.

NPI
1053469536
Provider Name
MICHAEL L MALONE MD
Gender
Male
Entity Type
Individual
Location Address
1020 N 12TH ST 3RD FLOOR MILWAUKEE, WI 53233
Location Phone
(414) 219-7300
Mailing Address
13475 COMMONS DR BROOKFIELD, WI 53005
Mailing Phone
(262) 781-8921
Is Sole Proprietor?
No
Enumeration Date
01-08-2007
Last Update Date
11-24-2021
Code Navigator

An internist like Michael Malone is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine Geriatric Medicine

Taxonomy Code
207RG0300X
Type
Allopathic & Osteopathic Physicians
License No.
26583-020
License State
WI
Taxonomy Description
An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - EPO
  • CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - EPO
  • CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Bronze Standard $7500 - EPO
  • CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold $0 Ded - EPO
  • CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold $3300 - EPO
  • CareSource (Common Ground Healthcare) Gold $3300 - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold Standard $2000 - EPO
  • CareSource (Common Ground Healthcare) Gold Standard $2000 - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - EPO
  • CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded - EPO
  • CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Silver Standard $6000 - EPO
  • CareSource (Common Ground Healthcare) Silver Standard $6000 - Vision Exam - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
31373200MEDICAID (05)WI 

Medicare Participation & PECOS Enrollment Status

Michael Malone is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient home visit, typically 40 minutes

An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.

This service was performed 17 times for 12 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 25 times for 24 patients

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 53233 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99205

  • Average New Patient Price $163.24
  • Minimum New Patient Price $53.9
  • Maximum New Patient Price $163.24
  • Average New Patient Copayment $40.81
  • Minimum New Patient Copayment $13.47
  • Maximum New Patient Copayment $40.81

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $95.41
  • Minimum Established Patient Price $17.4
  • Maximum Established Patient Price $133.76
  • Average Established Patient Copayment $23.85
  • Minimum Established Patient Copayment $4.35
  • Maximum Established Patient Copayment $33.44

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Reviews for MICHAEL L MALONE MD

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1053469536, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
3
Unchanged
Pos 5
4
Doubled → 8
Pos 6
6
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
5
Unchanged
Pos 9
3
Doubled → 6
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 4 → 8 9 → 18 → 9 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 0 + 3 + 8 + 6 + 1 + 8 + 5 + 6 + 24 = 64

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 64 is 70. The difference is the calculated check digit.

70 - 64 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1053469536.

Other Providers at the Same Location


The following 19 providers are registered at the same or a nearby location.

Advanced Practice Midwife
1020 N 12TH ST, 1ST FLOOR
MILWAUKEE, WI 53233
Advanced Practice Midwife
1020 N 12TH ST, 1ST FLOOR
MILWAUKEE, WI 53233
Advanced Practice Midwife
1020 N 12TH ST, 1ST FLOOR
MILWAUKEE, WI 53233
Advanced Practice Midwife
1020 N 12TH ST, 1ST FLOOR
MILWAUKEE, WI 53233
Advanced Practice Midwife
1020 N 12TH ST, 1ST FLOOR
MILWAUKEE, WI 53233
Pharmacy (Institutional Pharmacy)
1020 N 12TH ST
MILWAUKEE, WI 53233
Psychologist
1020 N 12TH ST, OUTPT HEALTH CENTER 4TH FLOOR
MILWAUKEE, WI 53233
Nurse Practitioner
1020 N 12TH ST, 2ND FLOOR
MILWAUKEE, WI 53233
Advanced Practice Midwife
1020 N 12TH ST, 1ST FL
MILWAUKEE, WI 53233
Nurse Practitioner
1020 N 12TH ST, 3RD FLOOR
MILWAUKEE, WI 53233
Family Medicine
1020 N 12TH ST, RM 3105
MILWAUKEE, WI 53233
Pediatrics
1020 N 12TH ST
MILWAUKEE, WI 53233
Psychologist
1020 N 12TH ST
MILWAUKEE, WI 53233
Nurse Practitioner (Pediatrics)
1020 N 12TH ST
MILWAUKEE, WI 53233
Dietitian, Registered
1020 N 12TH ST
MILWAUKEE, WI 53233
Internal Medicine
1020 N 12TH ST, INTERNAL MEDICINE CLINIC AURORA HEALTH CARE
MILWAUKEE, WI 53233
Internal Medicine
1020 N 12TH ST, 2ND FLOOR
MILWAUKEE, WI 53233
Clinic/Center (Mental Health (Including Community Mental Health Center))
1020 N 12TH ST
MILWAUKEE, WI 53233
Advanced Practice Midwife
1020 N 12TH ST, 1ST FLOOR
MILWAUKEE, WI 53233

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1053469536, enumerated as an "individual" on January 08, 2007.

The provider is located at 1020 N 12TH ST 3RD FLOOR MILWAUKEE, WI 53233 and the phone number is (414) 219-7300.

Internal Medicine with taxonomy code 207RG0300X and a focus in Geriatric Medicine.

The provider might be accepting Accepts: CareSource (Common Ground Healthcare), Medicare. Please consult your insurance carrier or call the provider to verify.