MARIA D MALLORY (MD) – Surgery Physician, NPI 1689664344
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
730 GENERAL SURGERY in MN
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Provider Addresses for MARIA D MALLORY (MD)
1200, 6th Avenue North, St. Cloud, Stearns County, Minnesota, 56303, United States
SAINT CLOUD, MN 563032735
Phone: (320) 252-5131
Fax: (320) 240-2118
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2005-08-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-10-31 (952 days ago).
Enrollment records
1
Earliest due date
2023-10-31
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 |
|---|---|---|---|---|
| I20050815000536 | I | General Surgery | MN | 2023-10-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 56303)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | MN | |
| Physical Therapist In Private Practice | MN | |
| Qualified Speech Language Pathologist | MN | |
| - | MN | |
| Family Practice | MN | |
| - | MN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MN | |
| - | MN | |
| Clinical Psychologist | NV | |
| - | UT |
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