NPIMap

Individual provider Active NPI

Malay R Das, MD

  • Internal Medicine Physician
  • Hawthorne, CA
National Provider Identifier
1164526224
Registry record updated Jul 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A34000 Issued in CA
Practice address
4477 W 118TH Street
Suite 409
Hawthorne, CA 90250
Phone
(310) 219-0647
Fax
(310) 219-4066
NPI assigned
Sep 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A34000 CA Primary

Addresses

Primary practice location

4477 W 118TH Street
Suite 409
Hawthorne, CA 90250

Mailing address

4477 W 118TH Street
Suite 409
Hawthorne, CA 90250
Phone (310) 219-0647

Other identifiers 1

IdentifierTypeStateIssuer
00A340000MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040624000787 CA Practitioner - NephrologyPractitioner - Internal Medicine 2769468503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1966
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4477 W 118TH St
Suite 409
Hawthorne, CA 90250-2259
Phone (310) 219-0647

Hospital & facility affiliations

  • DaVita Airport Sunrise Dialysis Center Dialysis facility, Inglewood, CA, CCN 052746
  • DaVita Hawthorne Dialysis Dialysis facility, Hawthorne, CA, CCN 552744
  • DaVita Torrance Emerald Dialysis Dialysis facility, Torrance, CA, CCN 552854
  • Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A34000CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
M R Das MD Inc a Medical Corporation CurrentSince Feb 8, 1999 Accepting new patients
Providence Health System Southern California Past Accepting new patients
Lincoln County Hospital District 3 Past Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients
Gardena Hospital LP Past Accepting new patients

Locations

4477 W 118th St
Ste 409
Hawthorne, CA 90250
Phone (310) 219-0647

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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 4

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": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280016000000",
    "number": "1164526224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4477 W 118TH STREET",
            "address_2": "SUITE 409",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "90250",
            "telephone_number": "310-219-0647",
            "fax_number": "310-219-4066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4477 W 118TH STREET",
            "address_2": "SUITE 409",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "90250",
            "telephone_number": "310-219-0647",
            "fax_number": "310-219-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAS",
        "first_name": "MALAY",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2010-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A34000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A340000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

Verify at the official NPI Registry.