NPIMap

Individual provider Active NPI

Rajitha Mallela, MBBS

  • Rheumatology Physician
  • Williamsville, NY
National Provider Identifier
1194038661
Registry record updated Oct 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
254835 Issued in NY
Practice address
295 Essjay Road
Buffalo Medical Group
Williamsville, NY 14221-8216
Phone
(716) 857-8749
Fax
(716) 250-5965
NPI assigned
Jul 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 254835 NY Primary

Addresses

Primary practice location

295 Essjay Road
Buffalo Medical Group
Williamsville, NY 14221-8216

Mailing address

49 Brantley CT
Getzville, NY 14068-1547
Phone (716) 510-0615

Other identifiers 1

IdentifierTypeStateIssuer
03258188MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20110115000047 NY Practitioner - RheumatologyPractitioner - Internal Medicine 7416146865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kidney and Hypertension Physician PCGroup PAC ID 6800080649, 4 clinicians

Practice addresses (Care Compare)

53 Elizabeth Dr
Lockport, NY 14094-5226
Phone (716) 650-0373

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
254835NYMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ecmc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: drmallela@kidneyandhypertension.medentdirect.com

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 9

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": "1280102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286496000000",
    "number": "1194038661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 BRANTLEY CT",
            "city": "GETZVILLE",
            "state": "NY",
            "postal_code": "140681547",
            "telephone_number": "716-510-0615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 ESSJAY ROAD",
            "address_2": "BUFFALO MEDICAL GROUP",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218216",
            "telephone_number": "716-857-8749",
            "fax_number": "716-250-5965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLELA",
        "first_name": "RAJITHA",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-26",
        "last_updated": "2010-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NY",
            "license": "254835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03258188",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.