MALLORY ELYSA DAWSON
NPI 1770444309
Nurse Practitioner - Gerontology in Berkeley, CA

Q: What is Mallory Dawson's NPI number?

The NPI number for Mallory Dawson is 1770444309. It was assigned to this individual provider in the NPPES registry on November 21, 2025.

Q: What is Mallory Dawson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for Mallory Dawson was last updated on November 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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 November 21, 2025PECOS EnrolledAccepts Medicare Assignment

1901 4TH ST STE 201, BERKELEY, CA 94710(510) 929-1400(510) 929-1414 Get Directions Write a Review

NPPES record last updated: November 21, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Mallory Elysa Dawson NPPES

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

MALLORY ELYSA DAWSON (NPI 1770444309) is an individual gerontology provider in Berkeley, California, licensed in California (95037603) and active in the NPI registry since November 2025. She is enrolled in Medicare PECOS and is a graduate of University Of California, San Francisco School Of Medicine (2025).

NPPES Registry Identity

NPI1770444309

Entity TypeIndividualFemale

Primary Taxonomy363LG0600X

Provider Legal NameMALLORY ELYSA DAWSON

Location Address1901 4TH ST STE 201Berkeley, CA 94710-1986

Mailing AddressPo Box 511250Los Angeles, CA 90051-7805 · (510) 929-1400 · Fax (510) 929-1414

Phone(510) 929-1400

Fax(510) 929-1414

Sole ProprietorNo

Medical School CMSUniversity Of California, San Francisco School Of MedicineGraduated 2025

Enumeration DateNovember 21, 2025

NPPES CertifiedNovember 21, 2025

✔ NPI 1770444309 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in CA · 95037603

1901 4TH ST STE 201, Berkeley, CA 94710

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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 Elysa Dawson 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 ID9234623034

PECOS Enrollment IDI20251209004011

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94710 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

$104.51 typical visit price

range $69.00 – $202.35

Typical copayment $26.12 (range $17.25 – $50.58)

Most-billed visit code 99203

Established Patient

$119.48 typical visit price

range $23.44 – $166.46

Typical copayment $29.87 (range $5.86 – $41.61)

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.

Other Providers at the Same Location NPPES 8

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

AMANDA MARIE ILAG AGNP

Nurse Practitioner (Primary Care)