GRANT W MALLORY (MD) – Neurological Surgery Physician, NPI 1568690477
Neurological Surgery Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
588 NEUROSURGERY in TX
Provider Addresses for GRANT W MALLORY (MD)
PO BOX 860912
MINNEAPOLIS, MN 554860912
Phone: (715) 838-5222
Type: Mailing
3551 Roger Brooke Dr
Fort Sam Houston, TX 782344504
Phone: (210) 916-3482
Type: Location
1400 BELLINGER ST
EAU CLAIRE, WI 547035222
Phone: (715) 838-5222
Type: Location
200 1st St SW
Rochester, MN 559050002
Phone: (303) 803-6953
Type: Location
Fairview Southdale Hospital, 6401, France Avenue South, Southdale, Edina, Hennepin County, Minnesota, 55435, United States
EDINA, MN 554352104
Phone: (612) 672-2294
Type: Mailing
Center for the Intrepid, 3551, Roger Brooke Drive, San Antonio, Bexar County, Texas, 78234, United States
FORT SAM HOUSTON, TX 782344504
Phone: (210) 916-3482
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $490.
Total Amount is formed as General ($490) + Research ($0) + Ownership ($0) = $490.
Last reported payment date: 2024-08-27 • Largest payer in this snapshot: SI-BONE, INC. ($301).
Total Amount
$490
General + Research + Ownership
Payments
8
Total payment records
General Amount
$490
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-27
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| SI-BONE, INC. | $301 |
| Medtronic, Inc. | $118 |
| DePuy Synthes Sales Inc. | $71 |
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: 2023-03-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20180427001227 | I | Neurosurgery | TX | TBD |
| I20230328000204 | I | Neurosurgery | WI | 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 55486)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| - | MN | |
| - | WI | |
| E N D O C R I N O L O G Y | CO | |
| - | MN | |
| - | WI | |
| - | WI | |
| Cardiovascular Disease (Cardiology) | MN | |
| - | WI | |
| N E U R O S U R G E R Y | FL |
Reviews
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