Active NPI
Mehreen Amjad Malik, MD
- Family Medicine Physician
- Dallas, TX
National Provider Identifier
1013112440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- M5343
- Practice address
- 3310 Live Oak St FL 3
Copc Administration
Dallas, TX 75204-6153 - Phone
- (214) 266-1000
- Fax
- (214) 266-1246
- NPI assigned
- Jun 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | M5343 | TX | Primary |
Addresses
Primary practice location
3310 Live Oak St FL 3
Copc Administration
Dallas, TX 75204-6153
Mailing address
PO Box 660599
Dallas, TX 75266-0599
Other identifiers 25
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 184901011 | Medicaid | TX | |
| 184901013 | Medicaid | TX | |
| 184901017 | Medicaid | TX | |
| 184901022 | Medicaid | TX | |
| 8W8855 | Other | TX | BLUE CROSS BLUE SHIELD |
| 184901004 | Medicaid | TX | |
| 184901023 | Medicaid | TX | |
| 184901005 | Medicaid | TX | |
| 184901007 | Medicaid | TX | |
| 184901014 | Medicaid | TX | |
| 184901021 | Medicaid | TX | |
| 184901024 | Medicaid | TX | |
| 184901003 | Medicaid | TX | |
| 184901012 | Medicaid | TX | |
| 184901020 | Medicaid | TX | |
| 184901002 | Medicaid | TX | |
| 184901006 | Medicaid | TX | |
| 184901009 | Medicaid | TX | |
| 184901008 | Medicaid | TX | |
| 184901001 | Medicaid | TX | |
| 184901010 | Medicaid | TX | |
| 184901016 | Medicaid | TX | |
| 184901015 | Medicaid | TX | |
| 184901019 | Medicaid | TX | |
| 184901025 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070723000170 | TX | Practitioner - Family Practice | 2163523051 |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1999
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
15 Grumman Rd W
Suite 1400
Bethpage, NY 11714-5029
PO Box
Los Angeles, CA 90084
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359331200000",
"number": "1013112440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 660599",
"city": "DALLAS",
"state": "TX",
"postal_code": "752660599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3310 LIVE OAK ST FL 3",
"address_2": "COPC ADMINISTRATION",
"city": "DALLAS",
"state": "TX",
"postal_code": "752046153",
"telephone_number": "214-266-1000",
"fax_number": "214-266-1246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALIK",
"first_name": "MEHREEN",
"middle_name": "AMJAD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-16",
"last_updated": "2013-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "M5343",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901011",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901013",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901017",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901022",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "8W8855",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901004",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901023",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901005",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901007",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901014",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901021",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901024",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901003",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901012",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901020",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901002",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901006",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901009",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901008",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901001",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901010",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901016",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901015",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901019",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184901025",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.