Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mallory C Edwards, PA-C

Individual provider Physician Assistant · NPI 1467876409

Mallory C Edwards, PA-C is a Physician Assistant in Granville, New York. Qualified in 2013, 13 years ago. Practices with Kaleida Health, a 214-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
13
Licensed in
NY
In the registry since
2014
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

79 N St
Granville, NY 12832-1137
Phone: (518) 642-0612
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 17875 Von Karman Ave Ste 150&250, Irvine, CA 92614-6200 — (855) 433-1680

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 017372 (NY)

Record details

NPI number1467876409
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 11, 2014
Last updated in NPPESApril 22, 2024
Certification dateApril 22, 2024
Mailing address79 North St, Granville, NY 12832-1137

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Kaleida Health — 214 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Granville