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JOSEPH MALONE MD
NPI 1891226932
Psychiatry & Neurology - Neurology in Pittsburgh, PA

Active since March 21, 2017PECOS EnrolledAccepts Medicare Assignment
77.5/100
CMS Quality Rating
3471 5TH AVE, PITTSBURGH, PA 15213(412) 692-4920 Get Directions Write a Review

NPPES record last updated: October 23, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 23, 2023, Sep 12, 2022, Mar 21, 2017 (3 updates tracked since 2017).

About Joseph Malone Md NPPES

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

JOSEPH MALONE MD (NPI 1891226932) is an individual neurology provider in Pittsburgh, Pennsylvania, licensed in Pennsylvania (MD477963) and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS, is affiliated with Garrett Regional Medical Center, and is a graduate of West Virginia University School Of Medicine (2017).

NPPES Registry Identity

NPI1891226932
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NameJOSEPH MALONECredential: MD
Location Address3471 5TH AVEPittsburgh, PA 15213-3215
Mailing Address3471 5th AvePittsburgh, PA 15213-3215 · (412) 692-4920
Phone(412) 692-4920
Sole ProprietorNo
Medical School CMSWest Virginia University School Of MedicineGraduated 2017
Enumeration DateMarch 21, 2017
Last NPPES UpdateOctober 23, 20233 updates tracked since enumeration
NPPES CertifiedOctober 23, 2023
✔ NPI 1891226932 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
License✔ Licensed in PA · MD477963
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
Also ListedPsychiatry & Neurology · Behavioral Neurology & NeuropsychiatryTaxonomy 2084B0040X · License MD477963 (PA)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
3471 5TH AVE, Pittsburgh, PA 15213
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Highmark Blue Cross Blue Shield West Virginia.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Joseph Malone 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 ID648655852
PECOS Enrollment IDI20240208002948
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Joseph Malone reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Pittsburgh Physicians
Same address
Internal Medicine
3500 5TH AVE, 4TH FLOOR
Pittsburgh, PA 15213
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 7,114 clinicians in this Medicare group
NPI 1548433527 (412) 682-2434
Wvu Med Corp Cheat Lake Physicians
53 mi
Clinical Medical Laboratory
2608 CRANBERRY SQUARE
Morgantown, WV 26508
  • Reassigned Medicare billing, West Virginia enrollment
  • Medicare enrollment name: West Virginia University Medical Corporation
  • 2,471 clinicians in this Medicare group
NPI 1568661148 (304) 293-5033

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
45 services45 patients
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.
45 services43 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.
38 services35 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
37 services37 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
29 services29 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
29 services29 patients

Hospital Affiliations CMS Care Compare 5

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

Garrett Regional Medical Center

Acute Care Hospitals · Oakland, MD
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number210017
Location251 North Fourth StreetOakland, MD 21550 · Garrett County
Emergency services Birthing friendly

West Virginia University Hospitals, Inc

Acute Care Hospitals · Morgantown, WV
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510001
Location1 Medical Center DriveMorgantown, WV 26506 · Monongalia County
Emergency services Birthing friendly

Berkeley Medical Center

Acute Care Hospitals · Martinsburg, WV
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510008
Location2500 Hospital DriveMartinsburg, WV 25401 · Berkeley County
Emergency services Birthing friendly

Thomas Memorial Hospital

Acute Care Hospitals · South Charleston, WV
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510029
Location4605 Maccorkle Avenue SWSouth Charleston, WV 25309 · Kanawha County
Emergency services Birthing friendly

Wheeling Hospital, Inc

Acute Care Hospitals · Wheeling, WV
1/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number510050
Location1 Medical ParkWheeling, WV 26003 · Ohio County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15213 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
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

77.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality68.61
Promoting Interoperability100
Improvement Activities40
Cost56.4

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.

DR. JOSEPH CHAK KA KWOK D.O.
Physical Medicine & Rehabilitation
3471 5TH AVE, KAUFMAN BUILDING SUITE 201
PITTSBURGH, PA 15213
Allegheny County (412) 648-6138
ALEXANDER PATRICK HOFFMAN M.D.
Orthopaedic Surgery
3471 5TH AVE, KAUFMANN MEDICAL BUILDING - SUITE 1010
PITTSBURGH, PA 15213
Allegheny County (412) 605-3277
ROBERT B NOLAND MD
Specialist
3471 5TH AVE, SUITE 102
PITTSBURGH, PA 15213
Allegheny County (412) 682-4005
MARIA BALDWIN MD
Psychiatry & Neurology (Epilepsy)
3471 5TH AVE, KAUFMANN BLDG. SUITE 810
PITTSBURGH, PA 15213
Allegheny County (412) 692-4920
LINDA SEKHON PA
Physician Assistant (Medical)
3471 5TH AVE
PITTSBURGH, PA 15213
Allegheny County (412) 647-8700
JAMIE ILGENFRITZ PA-C
Physician Assistant (Surgical)
3471 5TH AVE, SUITE 1010
PITTSBURGH, PA 15213
Allegheny County (412) 605-3900
UNIVERSITY OF PITTSBURGH PHYSICIANS
Orthopaedic Surgery
3471 5TH AVE, SUITE 102
PITTSBURGH, PA 15213
Allegheny County (412) 647-0100
MR. GUHA JAY GANESH
Student in an Organized Health Care Education/Training Program
3471 5TH AVE
PITTSBURGH, PA 15213
Allegheny County (412) 647-2345

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 Joseph Malone's NPI number?

The NPI number for Joseph Malone is 1891226932. It was assigned to this individual provider in the NPPES registry on March 21, 2017.

Where is Joseph Malone located?

Joseph Malone practices at 3471 5th Ave, Pittsburgh, PA 15213. The listed phone number is (412) 692-4920.

What is Joseph Malone's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Joseph Malone enrolled in Medicare?

Yes. Joseph 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.

Which organizations bill Medicare for Joseph Malone's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Joseph Malone reassigns Medicare benefits to 2 organizations: University Of Pittsburgh Physicians (Pittsburgh, PA) and Wvu Med Corp Cheat Lake Physicians (Morgantown, WV). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Joseph Malone's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Joseph Malone accept?

Health plans from CareSource and Highmark Blue Cross Blue Shield West Virginia list Joseph 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 Joseph Malone affiliated with any hospitals?

According to CMS data, Joseph Malone is affiliated with Garrett Regional Medical Center, West Virginia University Hospitals, Inc, Berkeley Medical Center, Thomas Memorial Hospital and Wheeling Hospital, Inc.

When was this NPI record last updated?

The NPPES record for Joseph Malone was last updated on October 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.