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Active NPI 1801540646 Individual Practitioner Female Practitioner

Mallory Quinn De Boom , PA

Physician Assistant • Germantown, TN

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Mallory De Boom, PA is a certified Physician Assistant practicing in Germantown, TN. With approximately 5 years of clinical experience since graduating from University Of Tennessee, Hsc, College Of Medicine in 2021, Mallory De Boom delivers high-quality medical care to the local community at 2004 EXETER RD.

Mallory De Boom is affiliated with Allina Health System and accepts Medicare assignment.

Frequently performed procedures and clinical services include routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only, new patient outpatient office visit, insertion of needle into vein for collection of blood sample. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

2004 Exeter Rd

Germantown, TN 381383945

Telephone 9016642111
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

University Of Tennessee, Hsc, College Of Medicine

Graduation Year

2021

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Germantown, TN

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
5 Yrs -3.9 yrs vs City Avg
City Avg: 8.9 Yrs
State Avg: 10.5 Yrs
Regional Practice Density
40 Specialists

Practicing in Germantown, TN (3096 Statewide)

Telehealth Adoption Rate
12.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
81.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. De Boom (5 Years) 5 Yrs
Germantown Specialty Average (8.9 Years) 8.9 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only
75 72 $40.00 $6.36
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
72 71 $575.00 $128.50
36415 Insertion of needle into vein for collection of blood sample
67 61 $15.00 $8.65
90833 Psychotherapy with evaluation and management visit, 30 minutes
32 31 $200.00 $55.94
96130 Evaluation of psychological test, first hour
16 16 $750.00 $96.05

Medical Specialties & State Licenses

CMS Verified: 2024-11-13
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License TN 4931

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Physician Assistant - Medical

NUCC Taxonomy Code: 363AM0700X

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Nccpa Certification
1191302 (TN)

Hospital & Practice Group Affiliations

Allina Health System

1540 Lake St S, Forest Lake, MN 550252628

Phone: 6514647100

Allina Health System

225 Smith Ave N, St Paul, MN 551022568

Phone: 6512417176

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1851300453

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location November 13, 2024

Registered at 2004 EXETER RD, GERMANTOWN, TN 381383945 (Tel: 9016642111)

📍
Updated Business Mailing Address November 13, 2024

Registered at 20770 US HIGHWAY 281 N # 108-439, SAN ANTONIO, TX 782587655

NPI Profile Active February 10, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location February 10, 2022

Registered at 1211 UNION AVE STE 495, MEMPHIS, TN 381046656 (Tel: 9015076600)

📍
Updated Business Mailing Address February 10, 2022

Registered at PO BOX 2044, MEMPHIS, TN 381012044 (Tel: 9015076600)

👤
Provider Name / Credentials Updated February 10, 2022

Recorded as MALLORY DE BOOM, PA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 10, 2022

Physician Assistant

🟢
Initial NPI Registration & Enumeration February 10, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1801540646
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 10, 2022
Last Update: November 13, 2024
Sole Proprietor: No

Mailing Address

20770 Us Highway 281 N # 108-439

San Antonio, TX 782587655

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.