Nasreen Azhar Mallik, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

34676 Issued in TN

Practice address

2495 Shreveport Hwy # 71
Pineville, LA 71360-4044

Phone

(318) 473-0010

Fax

(318) 483-5036

NPI assigned

Sep 20, 2006

Last updated

May 30, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Psychiatry

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mindcare Solutions PCGroup PAC ID 2466779855, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mindcare Solutions PC

  • Psychiatry Physician
  • Nashville, TN
  • NPI 1457015091
  Medicare reassignment Care Compare group NPD
• Alexandri VA Medical Center

  dba Psychiatry/Chemical Dependency

  • General Acute Care Hospital
  • Pineville, LA
  • NPI 1326123050
  NPD (past)
• Department of Veterans Affairs Medical Center

  • Long Term Care Hospital
  • Pineville, LA
  • NPI 1063594885
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1215034475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69004",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713069004",
            "telephone_number": "318-466-2593",
            "fax_number": "318-483-5091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 SHREVEPORT HWY # 71",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713604044",
            "telephone_number": "318-473-0010",
            "fax_number": "318-483-5036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLIK",
        "first_name": "NASREEN",
        "middle_name": "AZHAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "34676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Celeste Childress Luke, M.D.
• Edward Lytle, BCSAC
• Gwen Normand Maddox, LCSW
• Derek Maggio, PHARMD
• Carlos G Malave, M.D.
• Vincent D Mallory, MD
• Joy L Mancil, LPN2
• Jason Brian Manin, D.C.
• De'Shonta Renee Manning, PHARMD
• Ramona Leigh Mansell, LCSW

• Psychiatry Physician in Pineville, LA
• Providers in Pineville, LA by specialty
• Psychiatry Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.