MALLORY IRENE CHIANG – Physician Assistant, NPI 1174387773
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
Provider Addresses for MALLORY IRENE CHIANG
200 BLUE MOON XING STE 203
POOLER, GA 313229698
Phone: (912) 590-0973
Fax: (912) 590-0180
Type: Location
1601 Fair Rd Ste 800
Statesboro, GA 304580800
Phone: (912) 590-0973
Fax: (912) 590-0180
Type: Location
5191 FIRST COAST TECH PKWY FL 3
JACKSONVILLE, FL 322240609
Phone: (904) 256-2754
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 50 Open Payments records for all available years, with a total value of $3,233.
Total Amount is formed as General ($3,233) + Research ($0) + Ownership ($0) = $3,233.
Last reported payment date: 2024-12-20 • Largest payer in this snapshot: Boston Scientific Corporation ($2,360).
Total Amount
$3,233
General + Research + Ownership
Payments
50
Total payment records
General Amount
$3,233
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $2,360 |
| Curonix LLC | $388 |
| Vertos Medical, Inc. | $249 |
| Collegium Pharmaceutical, Inc. | $130 |
| Forte Bio-Pharma LLC | $39 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-07-02
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240702000385 | I | Physician Assistant | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 31322)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | GA | |
| Physician Assistant | GA | |
| Nurse Practitioner | FL | |
| Interventional Pain Management, Anesthesiology | GA | |
| Physician Assistant | GA | |
| Pain Management, Anesthesiology, Interventional Pain Management | GA | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | GA | |
| Pain Management, Interventional Pain Management, Physical Medicine And Rehabilitation | GA | |
| Physician Assistant | FL |
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