Individual provider Active NPI

Joseph Mahalli

  • Nephrology Physician
  • Lancaster, CA
National Provider Identifier
1023676376
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
20A19937 Issued in CA
Practice address
1759 W Avenue J Ste 101
Lancaster, CA 93534-2703
Phone
(661) 948-1388
Fax
(661) 948-1223
NPI assigned
Jun 2, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 20A19937 CA Primary

Addresses

Primary practice location

1759 W Avenue J Ste 101
Lancaster, CA 93534-2703

Mailing address

PO Box 2768
Lancaster, CA 93539-2768
Phone (661) 948-1388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250314002299 CA Practitioner - NephrologyPractitioner - Internal Medicine 1254853682 Reassigns benefits to 1 organization
I20250612002484 NY Practitioner - NephrologyPractitioner - Internal Medicine 1254853682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Antelope Valley Nephrology Medical Group IncGroup PAC ID 5395786206, 4 clinicians

Practice addresses (Care Compare)

1759 W Ave J
Suite 101
Lancaster, CA 93534-2703
Phone (661) 948-1388

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A19937CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Antelope Valley Nephrology Medical Group, Inc. CurrentSince Jan 13, 2025 Accepting new patients
Physician Affiliate Group of New York PC CurrentSince Mar 21, 2025 Accepting new patients

Locations

1759 W Avenue J
#101
Lancaster, CA 93534
Phone (661) 948-1388

212 S Richmond Rd
Ridgecrest, CA 93555
Phone (559) 432-5278

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jmahalli42910@direct.davitaphysiciansolutions.com

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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": "1559433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1023676376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2768",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935392768",
            "telephone_number": "661-948-1388",
            "fax_number": "661-948-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1759 W AVENUE J STE 101",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342703",
            "telephone_number": "661-948-1388",
            "fax_number": "661-948-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHALLI",
        "first_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-02",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "20A19937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.