Tayyab Malik, MD
Individual provider Active NPI Family Medicine Physician · Clifton, NJ
NPI 1003311937 · NPPES record last updated Sep 15, 2022
Key facts
- NPI
- 1003311937
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 25MA10900500 (NJ)
- Practice address
- 855 Valley Rd
Clifton, NJ 07013-2441 - Phone
- (201) 596-6262
- Fax
- (201) 596-6299
- NPI assigned
- Mar 23, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Baker Pediatrics LLC
Practice addresses (Care Compare)
34 The Promenade
Edgewater, NJ 07020-2127
Phone (551) 355-1200
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201116002122 | NJ | Practitioner - Family Practice | 6406267830 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA10900500 | NJ | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baker Pediatrics LLC | Family Medicine | Current |
Accepting new patients |
| Baker Health Medicine PLLC | Family Medicine | Past |
Accepting new patients |
Locations
855 Valley Rd
Ste 112
Clifton, NJ 07013
Phone (551) 355-1200
34 The Promenade
Edgewater, NJ 07020
Phone (551) 355-1200
250 Moonachie Rd
Ste 100
Moonachie, NJ 07074
Phone (201) 596-6262
250 Moonachie Rd
Moonachie, NJ 07074
Phone (201) 596-6262
510 Driggs Ave
Brooklyn, NY 11211
Phone (212) 315-8233
Interoperability endpoints
- https://api.platform.athenahealth.com/25246/brand/2/csg/1/fhir/r4
- tayyab.malik.1@25246.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 25MA10900500 | NJ | Yes |
Addresses
Primary practice location
855 Valley Rd
Clifton, NJ 07013-2441
Mailing address
250 Moonachie Rd
Moonachie, NJ 07074-1378
Phone (201) 596-6262
Other providers in Clifton, NJ
- Laura Majewski
- Palak Majmudar
- Gamil Lamey Makar
- Melba Malaran-Basta
- Vincent J Malba
- Beau Malimas
- Myleen Mamaril
- Andrew Manansala
- Maneyapanda LLC
- Jesse Mangone
All providers in Clifton, NJ · Family Medicine Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.