NPIMap

Individual provider Active NPI

Saadul Akbar Mallam, MD

  • Internal Medicine Physician
  • Newark, NJ
National Provider Identifier
1164058103
Registry record updated Jan 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA11728300 Issued in NJ
Practice address
201 Lyons Ave
Newark, NJ 07112-2027
Phone
(917) 926-7000
NPI assigned
Mar 22, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X NJ
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 25MA11728300 NJ Primary

Addresses

Primary practice location

201 Lyons Ave
Newark, NJ 07112-2027

Mailing address

201 Lyons Ave
Newark, NJ 07112-2027
Phone (917) 926-7000

Other names 1

  • Saadu Alhassan Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL RWJBarnabas

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230616002698 NJ Practitioner - Hospitalist 4981062320 Reassigns benefits to 1 organization
I20240514001857 NH Practitioner - Internal Medicine 4981062320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Plover Inpatient Services LLCGroup PAC ID 1355561663, 158 clinicians
Hospital Medicine Services of NH, LLCGroup PAC ID 8527423706, 88 clinicians

Practice addresses (Care Compare)

1 Bay Ave
Montclair, NJ 07042-4837
Phone (973) 429-6000

333 Borthwick Ave
Portsmouth, NH 03801-7128
Phone (603) 436-5110

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11728300NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine Services of NH, LLC Single Specialty CurrentSince May 29, 2024 Accepting new patients
HCA Health Services of New Hampshire Inc Past Accepting new patients

Locations

1 Parkland Dr
Derry, NH 03038
Phone (603) 421-2220

333 Bothwick Ave
Portsmouth, NH 03801
Phone (603) 433-4907

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

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.

Hospital & facility affiliations 8

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": "1584835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673654400000",
    "number": "1164058103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "917-926-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "917-926-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLAM",
        "first_name": "SAADUL",
        "middle_name": "AKBAR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-22",
        "last_updated": "2023-01-14",
        "certification_date": "2023-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA11728300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "RWJBarnabas",
            "affiliation": "N",
            "address_1": "201 Lyons Ave",
            "city": "Newark",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071122027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SAADU",
            "last_name": "ALHASSAN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.