Individual provider Active NPI

Priya Mallikarjuna, MD, MA

  • Pediatric Infectious Diseases Physician
  • Flushing, NY
National Provider Identifier
1053975250
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
318067 Issued in NY
Practice address
4500 Parsons Blvd
Pediatrics Department Room 410 1982 Building
Flushing, NY 11355
Phone
(516) 972-8109
NPI assigned
Apr 24, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Infectious Diseases Physician 2080P0208X 318067 NY Primary

Addresses

Primary practice location

4500 Parsons Blvd
Pediatrics Department Room 410 1982 Building
Flushing, NY 11355

Mailing address

2 Bel Air CT
Oyster Bay, NY 11771-4409
Phone (516) 972-8109

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250825003567 NY Practitioner - Pediatric Medicine 1456688993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

700 Hicksville Rd
Bethpage, NY 11714-3471

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Sep 1, 2025 Accepting new patients
New York University CurrentSince Sep 1, 2025 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325

500 1st Ave
New York, NY 10016
Phone (212) 562-4141

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: pmallikarjuna305508@nychhc.direct-ci.com
  • Direct secure messaging: pmallikarjuna730525@nyumc.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1053975250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 BEL AIR CT",
            "city": "OYSTER BAY",
            "state": "NY",
            "postal_code": "117714409",
            "telephone_number": "516-972-8109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 PARSONS BLVD",
            "address_2": "PEDIATRICS DEPARTMENT ROOM 410 1982 BUILDING",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11355",
            "telephone_number": "516-972-8109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLIKARJUNA",
        "first_name": "PRIYA",
        "credential": "MD, MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-24",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "NY",
            "license": "318067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.