JACLYN MALAT (D.O.) – Student in an Organized Health Care Education/Training Program, NPI 1417317637

JACLYN MALAT (D.O.) is a healthcare provider. based in Philadelphia, Pennsylvania. specializing in GENERAL SURGERY. They hold the professional credentials D.O.. The NPI Number for JACLYN MALAT (D.O.) is 1417317637

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
JACLYN MALAT (D.O.)
NPI
1417317637
Phone
(215) 871-6690
Address
4190 CITY AVE
Enumeration Date
1 March 2016
Last Update Date
1 March 2016

Doctor Profile

Medical School Name
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
9087886465
Graduation Year
2021 (5 years ago)
PAC ID
6204117930
Group Practice PAC ID
1759487762
Professional Enrollment ID
I20230211000411
Address ID
NJ088224600FL1100XDRXX316
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience25
Completeness75
Years active:10State licenses:0Digital endpointsOther names

1,999 GENERAL SURGERY in PA

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Provider Addresses for JACLYN MALAT (D.O.)

  • Rowland Hall, 4190, City Avenue, Pencoyd, Philadelphia, Philadelphia County, Pennsylvania, 19131, United States

    PHILADELPHIA, PA 191311626

    Phone: (215) 871-6690

    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)

CMS reports 1 Open Payments records for all available years, with a total value of $20.

Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.

Last reported payment date: 2024-02-20 • Largest payer in this snapshot: CSL Behring ($20).

Total Amount

$20

General + Research + Ownership

Payments

1

Total payment records

General Amount

$20

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-20

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
CSL Behring$20
View all Open Payments →|Open Payments Risk Radar →

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: 2023-02-11

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230211000411IGeneral SurgeryNJTBD

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.

Verify on CMS Revalidation Lookup Tool

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 19131)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1759487762View full group profile
NameSpecialtyState
-NJ
Colorectal Surgery (Proctology), General SurgeryPA
-NJ
General SurgeryNJ
General SurgeryVA

Reviews

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Frequently asked questions

What is the standard ID for JACLYN MALAT (D.O.) in the U.S.?
In the U.S., JACLYN MALAT (D.O.) is identified by NPI 1417317637.
Quick check: is JACLYN MALAT (D.O.) active?
Public NPPES data shows JACLYN MALAT (D.O.) with an active NPI status right now.
What does the directory say JACLYN MALAT (D.O.) does?
Insurance directories may phrase it differently, but here JACLYN MALAT (D.O.) maps to Student in an Organized Health Care Education/Training Program. Clinical services aligned with this taxonomy classification.
What geographic area is tied to JACLYN MALAT (D.O.)?
JACLYN MALAT (D.O.) is associated with Philadelphia, Pennsylvania in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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