Individual provider Active NPI

Deepa Malineni, DO

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1215020425
Registry record updated Jan 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
236954 Issued in NY
Practice address
MMG - Co-Op City
2100 Bartow Avenue
Bronx, NY 10475
Phone
(718) 320-5300
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2019

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 236954 NY Primary

Addresses

Primary practice location

MMG - Co-Op City
2100 Bartow Avenue
Bronx, NY 10475

Mailing address

2001 Marcus Ave
Ste E249
New Hyde Park, NY 11042-1000
Phone (718) 320-5300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051215000325 NY Practitioner - Internal Medicine 6406877687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Hematology Oncology Associates PCGroup PAC ID 1456243641, 474 clinicians

Practice addresses (Care Compare)

1061 N Broadway
Suite 2
North Massapequa, NY 11758-1853
Phone (631) 751-3000

48 Route 25a
Smithtown, NY 11787-1431
Phone (631) 751-3000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Leonardo N Saulle MD PC CurrentSince Nov 24, 2019 Accepting new patients
Montefiore Medical Center Internal Medicine Past Accepting new patients

Locations

2001 Marcus Ave
Ste E249
New Hyde Park, NY 11042

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1215020425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVE",
            "address_2": "STE E249",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421000",
            "telephone_number": "718-320-5300",
            "fax_number": "718-320-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MMG - CO-OP CITY",
            "address_2": "2100 BARTOW AVENUE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10475",
            "telephone_number": "718-320-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALINENI",
        "first_name": "DEEPA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "236954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.