1. Home
  2. Directory
  3. New Hampshire
  4. Pembroke
  5. Physician Assistant
  6. NPI Profile

MALLORY JACOB WALSH
NPI 1780151001
Physician Assistant in Pembroke, NH

Active since October 24, 2018PECOS Enrolled
100 MAIN ST APT 205, PEMBROKE, NH 03275(802) 274-8902 Get Directions Write a Review

NPPES record last updated: April 18, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 18, 2019, Oct 24, 2018 (2 updates tracked since 2018).

About Mallory Jacob Walsh NPPES

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

MALLORY JACOB WALSH (NPI 1780151001) is an individual physician assistant in Pembroke, New Hampshire, licensed in New Hampshire (1466) and active in the NPI registry since October 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780151001
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMALLORY JACOB WALSH
Location Address100 MAIN ST APT 205Pembroke, NH 03275-1241
Mailing Address111 New Hampshire Ave Ste 2Portsmouth, NH 03801-2864 · (603) 319-4490
Phone(802) 274-8902
Sole ProprietorYes
Enumeration DateOctober 24, 2018
Last NPPES UpdateApril 18, 20192 updates tracked since enumeration
✔ NPI 1780151001 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NH · 1466
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedClinic/Center · Urgent CareTaxonomy 261QU0200X
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
100 MAIN ST APT 205, Pembroke, NH 03275
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Harvard Pilgrim Health Care.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mallory Jacob Walsh is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 03275 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
$89.14 typical visit price
range $57.75 – $174.26
Typical copayment $22.28 (range $14.43 – $43.56)
Most-billed visit code 99203
Established Patient
$71.85 typical visit price
range $18.70 – $142.15
Typical copayment $17.96 (range $4.67 – $35.53)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Mallory Walsh's NPI number?

The NPI number for Mallory Walsh is 1780151001. It was assigned to this individual provider in the NPPES registry on October 24, 2018.

Where is Mallory Walsh located?

Mallory Walsh practices at 100 Main St Apt 205, Pembroke, NH 03275. The listed phone number is (802) 274-8902.

What is Mallory Walsh's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Mallory Walsh enrolled in Medicare?

Yes. Mallory Walsh is registered in the Medicare PECOS enrollment system.

What insurance does Mallory Walsh accept?

Health plans from Harvard Pilgrim Health Care list Mallory Walsh 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.

When was this NPI record last updated?

The NPPES record for Mallory Walsh was last updated on April 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.