Individual provider Active NPI

Maqsood Ahmad Malik, MD

  • Cardiovascular Disease Physician
  • Pottsville, PA
National Provider Identifier
1205809464
Registry record updated May 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD020363E Issued in PA
Practice address
106 S Claude a Lord Blvd
Pottsville, PA 17901-3637
Phone
(570) 622-4209
Fax
(570) 622-1386
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD020363E PA
Cardiovascular Disease Physician 207RC0000X MD020363E PA Primary

Addresses

Primary practice location

106 S Claude a Lord Blvd
Pottsville, PA 17901-3637

Mailing address

106 S Claude a Lord Blvd
Pottsville, PA 17901-3637
Phone (570) 622-4209

Other identifiers 10

IdentifierTypeStateIssuer
116993900OtherPAFEDERAL EMPLOYEES COMP
50047342OtherPACAPITAL BLUE CROSS
0000035926OtherPABLUE SHIELD
0473231OtherPAUS HEALTHCARE
110031029OtherPARAILROAD MEDICARE PBA
0006505600001MedicaidPA
01160701OtherPAKEYSTONE
0998130OtherPAKEYSTONE SPECIALIST
18452OtherPAGEISINGER HEALTH PLAN
203010OtherPAFEDERAL BLACK LUNG

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD020363EPAMDInternal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274140800000",
    "number": "1205809464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 S CLAUDE A LORD BLVD",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013637",
            "telephone_number": "570-622-4209",
            "fax_number": "570-622-1386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 S CLAUDE A LORD BLVD",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013637",
            "telephone_number": "570-622-4209",
            "fax_number": "570-622-1386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIK",
        "first_name": "MAQSOOD",
        "middle_name": "AHMAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2010-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD020363E",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD020363E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL EMPLOYEES COMP",
            "identifier": "116993900",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50047342",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "0000035926",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US HEALTHCARE",
            "identifier": "0473231",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PBA",
            "identifier": "110031029",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006505600001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "01160701",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE SPECIALIST",
            "identifier": "0998130",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH PLAN",
            "identifier": "18452",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "203010",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pottsville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.