DR. LISA M MALONE MD
NPI 1588647523
Obstetrics & Gynecology in Portage, IN
NPI Status: Active since November 23, 2005
Contact Information
6050 STERLING CREEK RD
PORTAGE, IN
ZIP 46368
Phone: (219) 763-8112
Fax: (219) 764-5380
- Individual
- Female
- Obstetrics & Gynecology
- Accepts Insurance
- PECOS Enrolled
- Medicare Quality Reporting
About LISA MALONE
This page provides the complete NPI Profile along with additional information for Lisa Malone, a women's health care provider established in Portage, Indiana with a medical specialization in Obstetrics & Gynecology. The healthcare provider is registered in the NPI registry with number 1588647523 assigned on November 2005. The practitioner's primary taxonomy code is 207V00000X with license number 036091949 (IL). The provider is registered as an individual and her NPI record was last updated 5 years ago.
- NPI
- 1588647523
- Provider Name
- DR. LISA M MALONE MD
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 6050 STERLING CREEK RD PORTAGE, IN 46368
- Location Phone
- (219) 763-8112
- Location Fax
- (219) 764-5380
- Mailing Address
- PO BOX 1430 PORTAGE, IN 46368
- Mailing Phone
- (219) 763-8112
- Mailing Fax
- (219) 764-5380
- Is Sole Proprietor?
- No
- Enumeration Date
- 11-23-2005
- Last Update Date
- 08-13-2020
- Code Navigator
Women's health care providers like Lisa Malone treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Obstetrics & Gynecology
- Taxonomy Code
- 207V00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 036091949
- License State
- IL
- Taxonomy Description
- An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Essential 6500 HSA (+ Incentives) - HMO
- Anthem Bronze Essential 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Essential 9200 (+ Incentives) - HMO
- Anthem Bronze Essential 9200 Adult Dental/Vision (+ Incentives) - HMO
- Anthem Bronze Essential POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Essential POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Essential 1500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Essential 2200 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Heart Healthy Bronze Essential 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Heart Healthy Silver Essential 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Essential 3500 HSA (+ Incentives) - HMO
- Anthem Silver Essential 5000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Essential 7000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Essential 7000 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Blue Choice Preferred Bronze PPO? 201 - PPO
- Blue Choice Preferred Bronze PPO? 701 - PPO
- Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
- Blue Choice Preferred Gold PPO? 204 - PPO
- Blue Choice Preferred Gold PPO? 901 - PPO
- Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
- Blue Choice Preferred Security PPO? 200 - PPO
- Blue Choice Preferred Silver PPO? 203 - PPO
- Blue Choice Preferred Silver PPO? 801 - PPO
- Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO
- MyBlue Plus Bronze? 903 - POS
- MyBlue Plus Bronze? 912 - POS
- MyBlue Plus Bronze? Standard - Select Rx Copays - POS
- MyBlue Plus Gold? 909 - POS
- MyBlue Plus Gold? 910 - POS
- MyBlue Plus Gold? Standard - Rx Copays - POS
- MyBlue Plus Silver? 905 - POS
- MyBlue Plus Silver? 906 - POS
- MyBlue Plus Silver? Standard - Select Rx Copays - POS
- Bronze First 7500 $25 Generic Drugs - HMO
- Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Gold 1500 $15 Generic Drugs - HMO
- Gold 1500 $15 Generic Drugs Adult Vision & Fitness - HMO
- HDHP Preventive Silver 5500 $0 Select Drugs - HMO
- Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services - HMO
- Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services - HMO
- Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- HSA Eligible Bronze 6000 - HMO
- Low Premium Bronze 9200 $25 Generic Drugs - HMO
- Low Premium Bronze 9200 $25 Generic Drugs Adult Vision & Fitness - HMO
- Low Premium Silver 6000 $3 Generic Drugs - HMO
- Low Premium Silver 6000 $3 Generic Drugs Adult Vision & Fitness - HMO
- Platinum Zero $5 Generic Drugs - HMO
- Platinum Zero $5 Generic Drugs Adult Vision & Fitness - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 036091949 | MEDICAID (05) | IL |
Medicare Participation & PECOS Enrollment Status
Lisa Malone is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
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 46368 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $122.49
- Minimum New Patient Price $53.07
- Maximum New Patient Price $161.76
- Average New Patient Copayment $30.62
- Minimum New Patient Copayment $13.26
- Maximum New Patient Copayment $40.44
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $66.48
- Minimum Established Patient Price $16.93
- Maximum Established Patient Price $132.22
- Average Established Patient Copayment $16.62
- Minimum Established Patient Copayment $4.23
- Maximum Established Patient Copayment $33.05
* 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.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
Reviews for DR. LISA M MALONE MD
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 5 | 8 | 8 | 6 | 4 | 7 | 5 | 2 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 5 | 16 | 8 | 12 | 4 | 14 | 5 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 5 + 1 + 6 + 8 + 1 + 2 + 4 + 1 + 4 + 5 + 4 + 24 = 67 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 67 = 3 | 3 | ||||||||
The NPI number 1588647523 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
DR. RAHEEL KHATRI D.M.D
Dentist
6050 STERLING CREEK RD
PORTAGE, IN
ZIP 46368
DR. DANIEL RALEIGH DEWAR D.C.
Chiropractor
6050 STERLING CREEK RD
PORTAGE, IN
ZIP 46368
DR. MICHAEL ANTHONY VILLANUEVA DC
Chiropractor
6050 STERLING CREEK RD
PORTAGE, IN
ZIP 46368
MICHELLE LYNN MCBRAYER LCSW
Social Worker
(Clinical)
6050 STERLING CREEK RD
PORTAGE, IN
ZIP 46368
DR. NIKKI A WARGO DDS
Dentist
6050 STERLING CREEK RD
PORTAGE, IN
ZIP 46368
DR. FRANK X WEILNHAMMER M.D.
Family Medicine
6050 STERLING CREEK RD
PORTAGE, IN
ZIP 46368
DR. ANDI ARNAUTOVIC MD
Family Medicine
6050 STERLING CREEK RD
PORTAGE, IN
ZIP 46368
ELIZABETH M MARCOTTE FNP
Nurse Practitioner
(Family)
6050 STERLING CREEK RD
PORTAGE, IN
ZIP 46368
MRS. SARAH L BRENTLINGER NP
Nurse Practitioner
(Family)
6050 STERLING CREEK RD
PORTAGE, IN
ZIP 46368
L. ALLEN GRECULA
Counselor
(Addiction (Substance Use Disorder))
6050 STERLING CREEK RD
PORTAGE, IN
ZIP 46368
MEGAN K WALKER
Nurse Practitioner
(Women's Health)
6050 STERLING CREEK RD
PORTAGE, IN
ZIP 46368
AUDREY SIMONE DAWSON OD
Optometrist
6050 STERLING CREEK RD
PORTAGE, IN
ZIP 46368
NORTHSHORE HEALTH CENTERS, INC.
Clinic/Center
(Federally Qualified Health Center (FQHC))
6050 STERLING CREEK RD
PORTAGE, IN
ZIP 46368
ROSHANDA GRAYSON-THOMAS APRN
Nurse Practitioner
(Psychiatric/Mental Health)
6050 STERLING CREEK RD
PORTAGE, IN
ZIP 46368
SPENCER SIMPSON
Nurse Practitioner
(Primary Care)
6050 STERLING CREEK RD
PORTAGE, IN
ZIP 46368
HEATHER MARIE PIEHL FNP-BC
Nurse Practitioner
(Family)
6050 STERLING CREEK RD
PORTAGE, IN
ZIP 46368
KAYLA JENKINS
Social Worker
6050 STERLING CREEK RD
PORTAGE, IN
ZIP 46368
MRS. MARY BETH BUSTOS MSN, APRN, FNP-C
Nurse Practitioner
(Family)
6050 STERLING CREEK RD
PORTAGE, IN
ZIP 46368
JULIJANA OBETKOVSKA
Family Medicine
6050 STERLING CREEK RD
PORTAGE, IN
ZIP 46368
GRETCHEN M HANEY MSN, APRN, FNP-BC
Family Medicine
6050 STERLING CREEK RD
PORTAGE, IN
ZIP 46368
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1588647523, enumerated as an "individual" on November 23, 2005.
The provider is located at 6050 STERLING CREEK RD PORTAGE, IN 46368 and the phone number is (219) 763-8112.
Obstetrics & Gynecology with taxonomy code 207V00000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Blue Cross and. Please consult your insurance carrier or call the provider to verify.
