Active NPI
Ghazala Sadruddin Malik, M.D.
- Emergency Medicine Physician
- Hamilton, OH
National Provider Identifier
1124076336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 35.070914
- Practice address
- 630 Eaton Ave
Hamilton, OH 45013-2767 - Phone
- (513) 867-2270
- Fax
- (513) 867-2581
- NPI assigned
- May 4, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35070914M | OH | |
| Emergency Medicine Physician | 207P00000X | 35.070914 | OH | Primary |
Addresses
Primary practice location
630 Eaton Ave
Hamilton, OH 45013-2767
Mailing address
4750 Hempstead Station Dr
Kettering, OH 45429-5164
Phone (800) 875-0136
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0381680 | Medicaid | OH | |
| 000000317069 | Other | OH | BCBS |
| P00074637 | Other | RAIL ROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.070914 | OH | MD | Emergency Medicine Physician |
| 35070914M | OH | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Professional Services, Inc. | Emergency Medicine | Current | Accepting new patients |
| Hamilton Emergency Physicians Inc | Emergency Medicine | Past | Accepting new patients |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000
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.
-
- Emergency Medicine Physician
- Seaman, OH
- NPI 1093762353
-
- Emergency Medicine Physician
- Hamilton, OH
- NPI 1992705933
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607990400000",
"number": "1124076336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4750 HEMPSTEAD STATION DR",
"city": "KETTERING",
"state": "OH",
"postal_code": "454295164",
"telephone_number": "800-875-0136",
"fax_number": "937-619-4231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 EATON AVE",
"city": "HAMILTON",
"state": "OH",
"postal_code": "450132767",
"telephone_number": "513-867-2270",
"fax_number": "513-867-2581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALIK",
"first_name": "GHAZALA",
"middle_name": "SADRUDDIN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-04",
"last_updated": "2020-12-15",
"certification_date": "2020-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "35070914M",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "OH",
"license": "35.070914",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0381680",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "000000317069",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD MEDICARE",
"identifier": "P00074637",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hamilton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.