NPIMap

Individual provider Active NPI

Mala T Kailasam, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1003849779
Registry record updated Mar 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
434586 Issued in PA
Practice address
333 Cottman Ave
Fox Chase Cancer Center
Philadelphia, PA 19111-2434
Phone
(215) 728-6900
Fax
(215) 214-1425
NPI assigned
Jul 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 434586 PA
Internal Medicine Physician 207R00000X 434586 PA Primary

Addresses

Primary practice location

333 Cottman Ave
Fox Chase Cancer Center
Philadelphia, PA 19111-2434

Mailing address

333 Cottman Ave
Medical Staff Office
Philadelphia, PA 19111-2434
Phone (215) 728-6900

Other identifiers 1

IdentifierTypeStateIssuer
1022444470001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170327000057 NJ Practitioner - Internal Medicine 7810952843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry J Austin Health Center, IncGroup PAC ID 9739179409, 23 clinicians

Practice addresses (Care Compare)

321 N Warren St
Trenton, NJ 08618-4741
Phone (609) 278-6029

Hospital & facility affiliations

  • Capital Health Regional Medical Center Hospital, Trenton, NJ, CCN 310092
  • Capital Health Medical Center - Hopewell Hospital, Pennington, NJ, CCN 310044
  • Robert Wood Johnson University Hospital at Hamilton Hospital, Hamilton, NJ, CCN 310110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
434586PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry J Austin Health Center, Inc Past Accepting new patients
Capital Health System Inc Past Accepting new patients
Health Services of Fox Chase Cancer Center Past Accepting new patients
Health Services of Fox Chase Cancer Center Past Accepting new patients
Capital Health System, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mala.kailasam.1@12521.direct.athenahealth.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/5bb47b8f-8587-42a0-80df-8d4eecf69db3/

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 13

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299542400000",
    "number": "1003849779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 COTTMAN AVE",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112434",
            "telephone_number": "215-728-6900",
            "fax_number": "215-214-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 COTTMAN AVE",
            "address_2": "FOX CHASE CANCER CENTER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112434",
            "telephone_number": "215-728-6900",
            "fax_number": "215-214-1425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAILASAM",
        "first_name": "MALA",
        "middle_name": "T",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2011-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "434586",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "434586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022444470001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.