| Dr Jason D Mallow, MD | |
|
3600 Minnesota Dr Ste 800, Edina, MN 55435-7915 | |
| (952) 595-1301 | |
| (612) 294-4903 |
| Full Name | Dr Jason D Mallow |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 15 Years |
| Location | 3600 Minnesota Dr Ste 800, Edina, Minnesota |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235423187 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 81764 (Georgia) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | 0101252666 (Virginia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Phoebe Putney Memorial Hospital | Albany, GA | Hospital |
| Self Regional Healthcare | Greenwood, SC | Hospital |
| Merit Health Natchez | Natchez, MS | Hospital |
| Southwestern Vermont Medical Center | Bennington, VT | Hospital |
| Donalsonville Hospital Inc | Donalsonville, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Northside Radiology Associates Llc | 4486555398 | 377 |
| Donalsonville Hospital Inc | 7113919820 | 59 |
| Virtual Radiologic Professionals Llc | 4981608817 | 425 |
| Atlantic Radiology Associates Llc | 5799706032 | 110 |
| North Georgia Radiology | 9032103296 | 36 |
| Carlos G Otis Health Care Center Inc | 6002726387 | 47 |
| Entity Name | Virtual Radiologic Professionals Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932342029 PECOS PAC ID: 4981608817 Enrollment ID: O20070201000069 |
| Entity Name | Donalsonville Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720095805 PECOS PAC ID: 7113919820 Enrollment ID: O20190313003226 |
| Entity Name | Northside Radiology Associates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013960657 PECOS PAC ID: 4486555398 Enrollment ID: O20201002002615 |
| Entity Name | North Georgia Radiology |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922193044 PECOS PAC ID: 9032103296 Enrollment ID: O20220802002590 |
| Entity Name | Atlantic Radiology Associates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033136080 PECOS PAC ID: 5799706032 Enrollment ID: O20240925003444 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jason D Mallow, MD 3600 Minnesota Dr Ste 800, Edina, MN 55435-7915 Ph: (952) 595-1301 | Dr Jason D Mallow, MD 3600 Minnesota Dr Ste 800, Edina, MN 55435-7915 Ph: (952) 595-1301 |
Christopher Calixte, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3600 Minnesota Dr Ste 800, Edina, MN 55435 Phone: 952-595-1100 Fax: 612-294-4903 | |
Paul D Guisler, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3600 Minnesota Dr Ste 800, Edina, MN 55435 Phone: 952-595-1301 Fax: 612-294-4903 | |
Krishna Vaidyanathan Iyer, M.D. Radiology Medicare: May Accept Medicare Assignments Practice Location: 3600 Minnesota Dr Ste 800, Edina, MN 55435 Phone: 952-595-1100 | |
Rati Narendra Patel, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3600 Minnesota Dr Ste 800, Edina, MN 55435 Phone: 952-595-1301 Fax: 612-294-4903 | |
Susanne S. Kim, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 3600 Minnesota Dr Ste 800, Edina, MN 55435 Phone: 952-595-1301 Fax: 612-294-4903 | |
Gwendolyn Durgin, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3600 Minnesota Dr Ste 800, Edina, MN 55435 Phone: 952-595-1301 Fax: 612-294-4903 | |
Robert L Edwards, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 3600 Minnesota Dr Ste 800, Edina, MN 55435 Phone: 952-595-1100 |