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MR. MICHAEL MALONE DO
NPI 1164508263
Family Medicine in Chicago, IL

Active since October 31, 2006PECOS EnrolledAccepts Medicare Assignment
5159 S. ASHLAND AVE, CHICAGO, IL 60609(773) 434-9216(773) 434-2670 Get Directions Write a Review

NPPES record last updated: February 11, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Michael Malone Do NPPES

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

MR. MICHAEL MALONE DO (NPI 1164508263) is an individual family medicine provider in Chicago, Illinois, licensed in Illinois (036-103685) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Mt Sinai Hospital Medical Center, and is a graduate of Chicago College Of Osteopathy (1997).

NPPES Registry Identity

NPI1164508263
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameMR. MICHAEL MALONECredential: DO
Location Address5159 S. ASHLAND AVEChicago, IL 60609-5322
Mailing Address5050 S State StChicago, IL 60609-5302 · (773) 924-5898 · Fax (773) 924-5791
Phone(773) 434-9216
Fax(773) 434-2670
Sole ProprietorNo
Medical School CMSChicago College Of OsteopathyGraduated 1997
Enumeration DateOctober 31, 2006
Last NPPES UpdateFebruary 11, 2014
✔ NPI 1164508263 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IL · 036-103685
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.
5159 S. ASHLAND AVE, Chicago, IL 60609
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Other Identifiers 3

Medicare UPINH48177
Medicare PIN367850IL
Medicaid036103685IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

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

Mr. Michael Malone 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 ID244229300
PECOS Enrollment IDI20040512000648
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 CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
56 services29 patients
Telephone medical discussion with physician, 21-30 minutes 99443
This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.
28 services14 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
20 services12 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
14 services14 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mt Sinai Hospital Medical Center

Acute Care Hospitals · Chicago, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140018
Location1500 S Fairfield AveChicago, IL 60608 · Cook County
Emergency services Birthing friendly

Holy Cross Hospital

Acute Care Hospitals · Chicago, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140133
Location2701 W 68th StreetChicago, IL 60629 · Cook County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60609 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
8 suppliers24 claims74 services$5.69 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
2 suppliers11 claims13 services$28.64 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers37 claims37 services$67.54 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
2 suppliers37 claims37 services$32.34 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
2 suppliers15 claims15 services$179.92 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Michael Malone's NPI number?

The NPI number for Michael Malone is 1164508263. It was assigned to this individual provider in the NPPES registry on October 31, 2006.

Where is Michael Malone located?

Michael Malone practices at 5159 S. Ashland Ave, Chicago, IL 60609. The listed phone number is (773) 434-9216.

What is Michael Malone's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Michael Malone enrolled in Medicare?

Yes. Michael Malone is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Michael Malone accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Michael Malone as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Michael Malone affiliated with any hospitals?

According to CMS data, Michael Malone is affiliated with Mt Sinai Hospital Medical Center and Holy Cross Hospital.

When was this NPI record last updated?

The NPPES record for Michael Malone was last updated on February 11, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.