NPIMap

Individual provider Active NPI

Ahsan Fayyaz Malik, M.D.

  • Internal Medicine Physician
  • Wilton, CT
National Provider Identifier
1164718045
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
052537 Issued in CT
Practice address
20 Old Ridgefield Rd
Wilton, CT 06897-3012
Phone
(203) 762-5588
Fax
(203) 762-2301
NPI assigned
Jun 20, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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 052537 CT Primary

Addresses

Primary practice location

20 Old Ridgefield Rd
Wilton, CT 06897-3012

Mailing address

20 Old Ridgefield Rd
Wilton, CT 06897-3012
Phone (203) 762-5588

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amalik222122@direct.stfranciscare.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20151022001559 CT Practitioner - Internal Medicine 8628387255 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midstate Medical CenterGroup PAC ID 7416840699, 187 clinicians

Practice addresses (Care Compare)

435 Lewis Ave
Meriden, CT 06451-2101
Phone (203) 694-8200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Midstate Medical Center CurrentSince Jun 1, 2018 Accepting new patients
Midstate Medical Center Current Accepting new patients
Trinity Health of New England Provider Network Organization Inc Internal Medicine CurrentSince Dec 19, 2021 Accepting new patients
Midstate Medical Center CurrentSince Jun 1, 2018 Accepting new patients
Trinity Health of New England Provider Network Organization Inc Internal Medicine CurrentSince Dec 19, 2021 Accepting new patients
Wilton Medical Associates PC PastSince Oct 13, 2015 Accepting new patients

Locations

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

Interoperability endpoints

  • Direct secure messaging: ahsan.malik@xdr.hhchealthdirect.org

Organizations & group practices 6

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 5

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": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1164718045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 OLD RIDGEFIELD RD",
            "city": "WILTON",
            "state": "CT",
            "postal_code": "068973012",
            "telephone_number": "203-762-5588",
            "fax_number": "203-762-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 OLD RIDGEFIELD RD",
            "city": "WILTON",
            "state": "CT",
            "postal_code": "068973012",
            "telephone_number": "203-762-5588",
            "fax_number": "203-762-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIK",
        "first_name": "AHSAN",
        "middle_name": "FAYYAZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-20",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "052537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amalik222122@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "CT Direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "56 Franklin St",
            "city": "Waterbury",
            "state": "CT",
            "country_code": "US",
            "postal_code": "067061253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilton, CT

Sources for this page

Verify at the official NPI Registry.