Gautam Malik, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME143824 Issued in FL

Practice address

3043 N Wilton Ave
2ND Floor
Chicago, IL 60657

Phone

(773) 296-5424

Fax

(773) 296-5280

NPI assigned

May 24, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, FL2 enrollments

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 2

Specialty

Internal Medicine

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Collins Physician Services, LLCGroup PAC ID 9234476920, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Home Care Plus Inc Home health agency, Doral, FL, CCN 109078
• Mount Sinai Medical Center of Florida, Inc Hospital, Miami Beach, FL, CCN 100034

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gmalik137535@direct.franciscanalliance.org

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.

• Collins Physician Services, LLC

  • Hospitalist Physician
  • Miami Beach, FL
  • NPI 1457839524

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Cogent Healthcare of Jacksonville, LLC

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1124252333
  Medicare reassignment NPD
• Cogent Healthcare of Jacksonville, LLC

  • Internal Medicine Physician
  • Port Orange, FL
  • NPI 1861150625
  NPD

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

• Home Care Plus Inc.

  • Home Health Agency
  • Doral, FL
  • NPI 1629280581
  Care Compare affiliation
• Mount Sinai Medical Center of Florida, Inc

  • General Acute Care Hospital
  • Miami Beach, FL
  • NPI 1912964768
  Care Compare affiliation

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

{
    "created_epoch": "1211587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1285892455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35318 EAGLE WAY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606781353",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3043 N WILTON AVE",
            "address_2": "2ND FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60657",
            "telephone_number": "773-296-5424",
            "fax_number": "773-296-5280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20201 Crawford Ave",
            "address_purpose": "LOCATION",
            "city": "Olympia Fields",
            "state": "IL",
            "postal_code": "604611010",
            "country_code": "US",
            "telephone_number": "844-740-4445",
            "fax_number": "708-679-2161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALIK",
        "first_name": "GAUTAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-24",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036-128378",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-128378",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME143824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IL5686064",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmalik137535@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "20201 Crawford Ave",
            "city": "Olympia Fields",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604611010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Aneeqa Angela Malik, D.D.S.
• Asad Malik, MD
• Bonnie Devroe Malik, CRNA
• Chelsea Malik, MS, LMFT
• Farrah Malik, MD
• Humza Imam Malik, LSW
• Kamran Naseem Malik, QMHP
• Kashif Munir Malik, MD
• Khalid Malik, MD
• Khalid M Malik, M.D.

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; 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.