MALLORY SHURTE TATE MD
NPI 1447644497
Specialist in San Diego, CA

Q: What is Mallory Tate's NPI number?

The NPI number for Mallory Tate is 1447644497. It was assigned to this individual provider in the NPPES registry on March 26, 2015. The provider is also known as Mallory Susan Shurte MD.

Q: What is Mallory Tate's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Q: When was this NPI record last updated?

The NPPES record for Mallory Tate was last updated on December 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since March 26, 2015PECOS EnrolledAccepts Medicare Assignment

3420 KENYON ST, SAN DIEGO, CA 92110(877) 496-0450 Get Directions Write a Review

NPPES record last updated: December 14, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 14, 2021, Feb 18, 2021, Jun 21, 2019 and 1 more (4 updates tracked since 2016).

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About Mallory Shurte Tate Md NPPES

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

MALLORY SHURTE TATE MD (NPI 1447644497) is an individual specialist in San Diego, California, licensed in California (A144255) and active in the NPI registry since March 2015. She is enrolled in Medicare PECOS and is a graduate of Louisiana State University School Of Medicine In New Orleans (2015).

NPPES Registry Identity

NPI1447644497

Entity TypeIndividualFemale

Primary Taxonomy174400000X

Provider Legal NameMALLORY SHURTE TATECredential: MD

Location Address3420 KENYON STSan Diego, CA 92110-5001

Mailing Address3420 Kenyon StSan Diego, CA 92110-5001 · (877) 496-0450

Phone(877) 496-0450

Sole ProprietorNo

Medical School CMSLouisiana State University School Of Medicine In New OrleansGraduated 2015

Enumeration DateMarch 26, 2015

Last NPPES UpdateDecember 14, 20214 updates tracked since enumeration

NPPES CertifiedDecember 14, 2021

✔ NPI 1447644497 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in CA · A144255

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

3420 KENYON ST, San Diego, CA 92110

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Other Names 1

Former Name (1)Mallory Susan Shurte Md

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

Mallory Shurte Tate 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 ID5597197756

PECOS Enrollment IDI20191111000287

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 20

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

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