Mallary West, DO
NPI 1164985917ActiveIndividual· Pediatrics· Edina, MN
Pediatrics (DO) in Edina, Minnesota, licensed in MN, with an NPI issued in April 2019. Enrolled in Medicare as order and referring only - pediatric medicine.
Overview
| NPI | 1164985917 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DO |
| Sole proprietor | Yes |
| NPI issued | Apr 9, 2019 |
| Last updated in NPPES | Jan 24, 2023 |
| Certified by provider | Jan 24, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pediatrics Primary | 208000000X | 71840 | MN |
| Student in an Organized Health Care Education/Training Program | 390200000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Order and Referring Only - Pediatric Medicine (MN) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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