Individual provider Active NPI

Mai Kamal El Mallah, MD

  • Pediatric Pulmonology Physician
  • Durham, NC
National Provider Identifier
1265548499
Registry record updated Jul 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
225653 Issued in NC
Practice address
CHC Erwin Road Duke University Medical Center
Durham, NC 27710
Phone
(919) 684-8657
Fax
(919) 684-2292
NPI assigned
Aug 21, 2006
Last updated
Jul 26, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 258806 MA
Pediatric Pulmonology Physician 2080P0214X 258806 MA
Pediatric Pulmonology Physician 2080P0214X ME114366 FL
Pediatric Pulmonology Physician 2080P0214X 225653 NC Primary

Addresses

Primary practice location

CHC Erwin Road Duke University Medical Center
Durham, NC 27710

Mailing address

Children's Health Center
Durham, NC 27710-0001
Phone (919) 684-3960

Other identifiers 4

IdentifierTypeStateIssuer
007206400MedicaidFL
S400170191OtherMAMEDICARE
110100625AMedicaidMA
177152901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20170905002260 NC Practitioner - Pediatric Medicine 9830119049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke Health Integrated Practice IncGroup PAC ID 8325412737, 3,140 clinicians

Practice addresses (Care Compare)

40 Duke Medicine Cir
Durham, NC 27710-4000
Phone (919) 684-8111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
225653NCMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients

Locations

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-1300

Interoperability endpoints

  • Direct secure messaging: melmallah306065@direct.medicine.duke.edu

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1265548499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CHILDREN'S HEALTH CENTER",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277100001",
            "telephone_number": "919-684-3960",
            "fax_number": "919-684-2292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CHC ERWIN ROAD DUKE UNIVERSITY MEDICAL CENTER",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27710",
            "telephone_number": "919-684-8657",
            "fax_number": "919-684-2292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EL MALLAH",
        "first_name": "MAI",
        "middle_name": "KAMAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "258806",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "MA",
            "license": "258806",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "FL",
            "license": "ME114366",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NC",
            "license": "225653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007206400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "S400170191",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110100625A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177152901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.