Shayne Lynne Mangalindan Malik

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN9372179 Issued in FL

Practice address

9765 San Jose Blvd
Ste. 102
Jacksonville, FL 32257-4402

Phone

(904) 260-5757

Fax

(904) 268-0733

NPI assigned

Sep 16, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/26160/brand/1/csg/1/fhir/r4

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.

• St Vincents Ambulatory Care Inc

  • Neurological Surgery Physician
  • Jacksonville, FL
  • NPI 1417987124
  Medicare reassignment NPD
• Vitae Health Medical Florida PLLC

  • Internal Medicine Physician
  • Rockledge, FL
  • NPI 1013562024
  Medicare reassignment NPD
• St Vincents Ambulatory Care Inc

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
  • NPI 1679226690
  NPD
• River City Nephrology PLLC

  • Nephrology Physician
  • Jacksonville, FL
  • NPI 1093450652
  NPD (past)

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

{
    "created_epoch": "1473984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1073061214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9765 SAN JOSE BLVD",
            "address_2": "STE. 102",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322574402",
            "telephone_number": "904-260-5757",
            "fax_number": "904-268-0733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9765 SAN JOSE BLVD",
            "address_2": "STE. 102",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322574402",
            "telephone_number": "904-260-5757",
            "fax_number": "904-268-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIK",
        "first_name": "SHAYNE LYNNE",
        "middle_name": "MANGALINDAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-16",
        "last_updated": "2022-12-22",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9372179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hanna Fayyaz Malik, DO
• Kashif Zia Malik, MD
• Nushrah Naveed Malik, MD, MBA
• Saadia Aurangzeb Malik, M.D.,
• Sehrish Malik, MD
• Jill Maliszewski
• Ray E Mallari
• Jorge Mallea, MD
• Daniel Malleske, MD
• Kerry Cronin Mallini, PT, NCS

• Family Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.