Individual provider Active NPI

Vijaya L Mallela, M.D.

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1154354587
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J6836 Issued in TX
Practice address
4755 Aldine Mail Rd
Houston, TX 77039-5934
Phone
(281) 985-7600
Fax
(281) 985-7607
NPI assigned
Jul 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X J6836 TX Primary

Addresses

Primary practice location

4755 Aldine Mail Rd
Houston, TX 77039-5934

Mailing address

4755 Aldine Mail Route Rd
Houston, TX 77039-5934
Phone (281) 985-7600

Other identifiers 3

IdentifierTypeStateIssuer
88Y325OtherTXBCBS
134643901OtherTXCSHCN
134643902MedicaidTX

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100329000361 TX Practitioner - Family Practice 6406982529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians

Practice addresses (Care Compare)

4755 Aldine Mail Route Rd
Houston, TX 77039-5934
Phone (281) 985-7600

4755 Aldine Mail Rte
Houston, TX 77039-5934
Phone (281) 985-7617

5656 Kelley St
Houston, TX 77026-1967
Phone (713) 566-4635

6410 Fannin St
Houston, TX 77030-3005

Hospital & facility affiliations

  • Harris Health Hospital, Houston, TX, CCN 450289

Merit-based Incentive Payment System (MIPS)

Final score
84.11 of 100Reported as group
Quality
69.15
Promoting interoperability
100
Improvement activities
40
Cost
73.63

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians Family Medicine CurrentSince Dec 9, 1994 Accepting new patients
Ut Physicians CurrentSince Dec 9, 1994 Accepting new patients

Locations

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

5656 Kelley St
Houston, TX 77026
Phone (713) 566-5000

4755 Aldine Mail Rte
Houston, TX 77039
Phone (281) 985-7600

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 1

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1154354587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4755 ALDINE MAIL ROUTE RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770395934",
            "telephone_number": "281-985-7600",
            "fax_number": "281-985-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 ALDINE MAIL RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770395934",
            "telephone_number": "281-985-7600",
            "fax_number": "281-985-7607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLELA",
        "first_name": "VIJAYA",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J6836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "88Y325",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "134643901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134643902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.