SHELDON D. E. MALCOLM DO
NPI 1104054261
Family Medicine in Providence, RI

Active since June 29, 2009PECOS EnrolledAccepts Medicare Assignment
355 PRAIRIE AVE, PROVIDENCE, RI 02905(401) 444-0570(401) 444-0427 Get Directions Write a Review

NPPES record last updated: May 7, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Sheldon D. E. Malcolm Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHELDON D. E. MALCOLM DO (NPI 1104054261) is an individual family medicine provider in Providence, Rhode Island, licensed in Rhode Island (DO00835) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS, maintains a secondary practice location in North Dartmouth, and is a graduate of University Of New England, College Of Osteo Medicine (2009).

NPPES Registry Identity

NPI1104054261
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameSHELDON D. E. MALCOLMCredential: DO
Location Address355 PRAIRIE AVEProvidence, RI 02905
Mailing Address375 Allens AveProvidence, RI 02905-5010 · (401) 444-0400 · Fax (401) 444-0468
Fax(401) 444-0427
Sole ProprietorNo
Medical School CMSUniversity Of New England, College Of Osteo MedicineGraduated 2009
Enumeration DateJune 29, 2009
Last NPPES UpdateMay 7, 2019
NPI 1104054261 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses Licensed in RI · DO00835 Licensed in MA · 254236
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

355 PRAIRIE AVE, Providence, RI 02905

Secondary Practice Location 1

Location 1300A Faunce Corner RoadNorth Dartmouth, MA 02747 · Phone (508) 995-6381 · Fax (508) 995-6389

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Sheldon D. E. Malcolm Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1052553989
PECOS Enrollment IDI20130806000463, I20160811002541
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

Blood glucose (sugar) test performed by hand-held instrument

A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.

This service was performed 30 times for 23 patients

Hemoglobin a1c level

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

This service was performed 27 times for 21 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $22.62 for a new patient copayment and $25.77 for an established patient copayment.

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 02905 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $90.48
  • Minimum New Patient Price $58.57
  • Maximum New Patient Price $177.03
  • Average New Patient Copayment $22.62
  • Minimum New Patient Copayment $14.64
  • Maximum New Patient Copayment $44.25

Established Patients Visit Costs *

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

  • Average Established Patient Price $103.1
  • Minimum Established Patient Price $18.92
  • Maximum Established Patient Price $144.38
  • Average Established Patient Copayment $25.77
  • Minimum Established Patient Copayment $4.73
  • Maximum Established Patient Copayment $36.09

* 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.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Counselor
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Counselor
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Counselor
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Registered Nurse
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Pediatrics
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Community Health Worker
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Counselor
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Registered Nurse
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Family Medicine
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Internal Medicine
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Internal Medicine
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Family Medicine
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Family Medicine
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Nurse Practitioner (Family)
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Pediatrics
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Nurse Practitioner (Pediatrics)
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Family Medicine (Adult Medicine)
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Nurse Practitioner (Family)
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Counselor
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Family Medicine
355 PRAIRIE AVE
PROVIDENCE, RI 02905

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104054261, enumerated as an "individual" on June 29, 2009.

The provider is located at 355 PRAIRIE AVE PROVIDENCE, RI 02905 and the phone number is (401) 444-0570.

Family Medicine with taxonomy code 207Q00000X.