Individual provider Active NPI

Tayyaba K Malik, M.D.

  • Pediatrics Physician
  • Jersey City, NJ
National Provider Identifier
1306956164
Registry record updated Apr 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MA60432 Issued in NJ
Practice address
127 Palisade Ave
Jersey City, NJ 07306-1101
Phone
(201) 217-1000
NPI assigned
Aug 30, 2006
Last updated
Apr 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MA60432 NJ Primary

Addresses

Primary practice location

127 Palisade Ave
Jersey City, NJ 07306-1101

Mailing address

7 Jenna LN
Edison, NJ 08820-1050
Phone (201) 217-1000

Other practice location 1

2749 John F Kennedy Blvd
Jersey City, NJ 07306-5540
Phone (848) 219-5213

Other identifiers 1

IdentifierTypeStateIssuer
6186106MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL PediPractices Other Pedi Practices

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA60432NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pedi Practices Current Accepting new patients
Hudson Hospital Opco LLC Current Accepting new patients
Reliance Medical Group, LLC Pediatrics Past Accepting new patients
Pediatric Practice Pediatrics Past Accepting new patients
Jersey City Medical Center Past Accepting new patients
Reliance Medical Group LLC PastSince Dec 1, 2016 Accepting new patients
Westside Pediatrics,P.a. Pediatrics Past Accepting new patients

Locations

127 Palisade Ave
Jersey City, NJ 07306
Phone (201) 217-1000

Interoperability endpoints

  • Direct secure messaging: tayyaba.malik@direct.christhospital.md

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, 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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681516800000",
    "number": "1306956164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 JENNA LN",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088201050",
            "telephone_number": "201-217-1000",
            "fax_number": "201-217-3118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 PALISADE AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073061101",
            "telephone_number": "201-217-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2749 John F Kennedy Blvd",
            "address_purpose": "LOCATION",
            "city": "Jersey City",
            "state": "NJ",
            "postal_code": "073065540",
            "country_code": "US",
            "telephone_number": "848-219-5213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALIK",
        "first_name": "TAYYABA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-04-15",
        "certification_date": "2023-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "MA60432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6186106",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "PediPractices",
            "affiliation": "Y",
            "endpointDescription": "Practice Business Name",
            "affiliationName": "Pedi Practices",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Business Tax and Billing",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Paper and ELectronic",
            "address_1": "127 Palisade Ave",
            "city": "Jersey City",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "073061101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.