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EDWARD J MALONE III MD
NPI 1194786673
Family Medicine in La Crosse, WI

Active since April 01, 2006PECOS EnrolledAccepts Medicare Assignment
815 10TH STREET S., LA CROSSE, WI 54601(608) 392-7390 Get Directions Write a Review

NPPES record last updated: September 15, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Edward J Malone Iii Md NPPES

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

EDWARD J MALONE III MD (NPI 1194786673) is an individual family medicine provider in La Crosse, Wisconsin, licensed in Wisconsin (34774) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Winona Health Services, and is a graduate of Rush Medical College Of Rush University (1992).

NPPES Registry Identity

NPI1194786673
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameEDWARD J MALONE IIICredential: MD
Location Address815 10TH STREET S.La Crosse, WI 54601-4700
Mailing Address815 10th Street S.La Crosse, WI 54601-4700 · (608) 392-7390
Phone(608) 392-7390
Sole ProprietorNo
Medical School CMSRush Medical College Of Rush UniversityGraduated 1992
Enumeration DateApril 1, 2006
Last NPPES UpdateSeptember 15, 2020
NPPES CertifiedSeptember 15, 2020
✔ NPI 1194786673 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in WI · 34774✔ Licensed in MN · 38245
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.
815 10TH STREET S., La Crosse, WI 54601
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Other Identifiers 1

Medicaid171717100MN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Security Health Plan.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

Edward J Malone Iii Md 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 ID941229496
PECOS Enrollment IDI20051208000332
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 9

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 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.
207 services125 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
164 services69 patients
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.
113 services100 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
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.
64 services61 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.
38 services38 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
24 services24 patients

Hospital Affiliations CMS Care Compare 4

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

Winona Health Services

Acute Care Hospitals · Winona, MN
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240044
Location855 Mankato AvenueWinona, MN 55987 · Winona County
Emergency services Birthing friendly

Mayo Clinic Health System-Franciscan Medical Center Inc

Acute Care Hospitals · La Crosse, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520004
Location700 West Avenue SouthLa Crosse, WI 54601 · La Crosse County
Emergency services Birthing friendly

Mayo Clinic Hlth Systm Franciscan Hlthcare Sparta

Critical Access Hospitals · Sparta, WI
OwnershipVoluntary non-profit - Church
CMS Certification Number521305
Location310 W Main StSparta, WI 54656 · Monroe County
Emergency services

Black River Memorial Hospital

Critical Access Hospitals · Black River Falls, WI
OwnershipVoluntary non-profit - Private
CMS Certification Number521333
Location711 W Adams StBlack River Falls, WI 54615 · Jackson County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54601 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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 3

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 suppliers20 claims65 services$4.16 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
1 supplier13 claims13 services$84.17 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 suppliers12 claims12 services$169.18 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 Edward Malone's NPI number?

The NPI number for Edward Malone is 1194786673. It was assigned to this individual provider in the NPPES registry on April 1, 2006.

Where is Edward Malone located?

Edward Malone practices at 815 10th Street S., La Crosse, WI 54601. The listed phone number is (608) 392-7390.

What is Edward Malone's specialty?

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

Is Edward Malone enrolled in Medicare?

Yes. Edward 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 Edward Malone accept?

Health plans from Anthem Blue Cross and Blue Shield and Security Health Plan list Edward 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 Edward Malone affiliated with any hospitals?

According to CMS data, Edward Malone is affiliated with Winona Health Services, Mayo Clinic Health System-Franciscan Medical Center Inc, Mayo Clinic Hlth Systm Franciscan Hlthcare Sparta and Black River Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Edward Malone was last updated on September 15, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.