Physician Compare National (NPI:1497726814)

HEALTHCARE PROVIDER: RANDOLPH AUGUSTUS MALONE IV M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1497726814
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2567597438
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180525000883
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MALONE
	Individual professional last name
Provider First Name	RANDOLPH
	Individual professional first name
Provider Middle Name	AUGUSTUS
	Individual professional middle name
Provider Name Suffix Text	IV
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1985
	Individual professional's medical school graduation year
Primary Specialty	ALLERGY/IMMUNOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	OVERLAND PARK SURGICAL SPECIALTIES LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	9234318502
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	112
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	11725 W 112TH ST
	Group Practice or individual's line 1 address
City	OVERLAND PARK
	Group Practice or individual's city
State	KS
	Group Practice or individual's state
Zip Code	662102761
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9134695452
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y