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MRS. JENNIFER REBECCA MALLOY PA-C
NPI 1114008554
Physician Assistant - Surgical in Campbell, CA

Active since October 18, 2006PECOS Enrolled
2255 S BASCOM AVE, SUITE 200, CAMPBELL, CA 95008(408) 376-3626(408) 871-2377 Get Directions Write a Review

NPPES record last updated: February 26, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Jennifer Rebecca Malloy Pa-c NPPES

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

MRS. JENNIFER REBECCA MALLOY PA-C (NPI 1114008554) is an individual surgical provider in Campbell, California, licensed in California (PA17849) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114008554
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameMRS. JENNIFER REBECCA MALLOYCredential: PA-C
Location Address2255 S BASCOM AVE, SUITE 200Campbell, CA 95008-7800
Mailing Address2255 S Bascom Ave, Suite 200Campbell, CA 95008-7800 · (408) 376-3626 · Fax (408) 871-2377
Phone(408) 376-3626
Fax(408) 871-2377
Sole ProprietorYes
Enumeration DateOctober 18, 2006
Last NPPES UpdateFebruary 26, 2010
✔ NPI 1114008554 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in CA · PA17849
2255 S BASCOM AVE, Campbell, CA 95008
Open in Google Maps ↗

Other Identifiers 1

Medicare UPINQ60782CA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Jennifer Rebecca Malloy Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SOUTH BAY ANGIOGRAPHY AND INTERVENTIONAL CENTER
Specialist
2255 S BASCOM AVE, SUITE 200
CAMPBELL, CA 95008
Santa Clara County (408) 376-3626
RYAN GUPTA M.D.
Surgery (Vascular Surgery)
2255 S BASCOM AVE
CAMPBELL, CA 95008
Santa Clara County (408) 376-3626
DR. POLYXENE G. KOKINOS MD
Specialist
2255 S BASCOM AVE, STE 200
CAMPBELL, CA 95008
Santa Clara County (408) 376-3626

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jennifer Malloy's NPI number?

The NPI number for Jennifer Malloy is 1114008554. It was assigned to this individual provider in the NPPES registry on October 18, 2006.

Where is Jennifer Malloy located?

Jennifer Malloy practices at 2255 S Bascom Ave Suite 200, Campbell, CA 95008. The listed phone number is (408) 376-3626.

What is Jennifer Malloy's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Jennifer Malloy enrolled in Medicare?

Yes. Jennifer Malloy is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jennifer Malloy was last updated on February 26, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.