NPIMap

Individual provider Active NPI

Radmila Mallah, CRNP

  • Adult Health Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1245558832
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP010776 Issued in PA
Practice address
9892 Bustleton Ave Ste 101
Philadelphia, PA 19115-2138
Phone
(215) 676-2741
Fax
(215) 676-2796
NPI assigned
May 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP010776 PA Primary

Addresses

Primary practice location

9892 Bustleton Ave Ste 101
Philadelphia, PA 19115-2138

Mailing address

3500 N Broad St RM 1a
Philadelphia, PA 19140-4106
Phone (215) 707-2433

Other names 1

  • Radmila Gaisinsky Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20101110001159 PA Practitioner - Nurse Practitioner 1951596303 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Temple Physicians IncGroup PAC ID 2062317233, 154 clinicians

Practice addresses (Care Compare)

10100 Jamison Ave
RM 227
Philadelphia, PA 19116-3832
Phone (215) 969-1404

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP010776PAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physicians Inc Current Accepting new patients
Temple Physicians Inc CurrentSince Nov 1, 2016 Accepting new patients
Eugene Dyakovetsky MD. PC. CurrentSince Jul 11, 2014 Accepting new patients
Psychogeriatric Services LLC CurrentSince May 1, 2021 Accepting new patients
Comprehensive Care Medical Associates P C CurrentSince Mar 1, 2016 Accepting new patients
Temple Physician Inc. CurrentSince Nov 1, 2016 Accepting new patients
Temple Physicians Inc. Past Accepting new patients

Locations

12073 Tech Rd
Ste B
Silver Spring, MD 20904
Phone (240) 396-5873

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

595 Biglerville Rd
Gettysburg, PA 17325
Phone (717) 334-6249

146 E King St
Lancaster, PA 17602
Phone (302) 990-2323

100 N Buckstown Rd
Ste E206
Langhorne, PA 19047
Phone (215) 741-1963

12000 Bustleton Ave
Ste 102
Philadelphia, PA 19116
Phone (215) 673-7600

3500 N Broad St
Rm 1A
Philadelphia, PA 19140
Phone (215) 707-2433

650 Edison Ave
Philadelphia, PA 19116
Phone (215) 673-5700

10100 Jamison Ave
Rm 227
Philadelphia, PA 19116
Phone (215) 969-1404

Organizations & group practices 7

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1273190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1245558832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 N BROAD ST RM 1A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404106",
            "telephone_number": "215-707-2433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9892 BUSTLETON AVE STE 101",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191152138",
            "telephone_number": "215-676-2741",
            "fax_number": "215-676-2796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLAH",
        "first_name": "RADMILA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-07",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP010776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RADMILA",
            "last_name": "GAISINSKY",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.