Individual provider Active NPI

Brian Ibrahim Malki, M.D.

  • Anesthesiology Physician
  • Little Rock, AR
National Provider Identifier
1346620697
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
E13184 Issued in AR
Practice address
108 N Shackleford Rd
Little Rock, AR 72211-2840
Phone
(844) 215-8731
Fax
(888) 630-8885
NPI assigned
Jun 2, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X E13184 AR Primary

Addresses

Primary practice location

108 N Shackleford Rd
Little Rock, AR 72211-2840

Mailing address

108 N Shackleford Rd
Little Rock, AR 72211-2840
Phone (586) 488-8464

Other practice location 1

4201 St. Antoine St
9C-Uhc
Detroit, MI 48201
Phone (313) 745-5146 ext. 5147

Other identifiers 1

IdentifierTypeStateIssuer
E-13184OtherARSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20200521002405 AR Practitioner - Anesthesiology 5193027811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pain Treatment Centers of America PLLCGroup PAC ID 2769608819, 73 clinicians

Practice addresses (Care Compare)

1502 SE 28TH St
Suite 8
Bentonville, AR 72712-0076
Phone (501) 773-6993

Hospital & facility affiliations

  • Conway Regional Medical Center, Inc Hospital, Conway, AR, CCN 040029
  • Ozark Health Hospital, Clinton, AR, CCN 041313
  • St Marys Regional Medical Center Hospital, Russellville, AR, CCN 040041

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E13184ARMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Treatment Centers of America PLLC CurrentSince Jul 15, 2020 Accepting new patients
Pain Treatment Centers of America, PLLC CurrentSince Jul 15, 2020 Accepting new patients
Hot Springs Ambulatory Surgery Center, LLC Past Accepting new patients
Conway Ambulatory Surgery Center, LLC Past Accepting new patients

Locations

1215 Sidney St
Batesville, AR 72501
Phone (870) 262-1541

2902 Mid Cities Dr
Bentonville, AR 72712
Phone (870) 916-5500

1502 SE 28th St
Ste 8
Bentonville, AR 72712
Phone (479) 273-1033

2425 Dave Ward Dr
Ste 301
Conway, AR 72034
Phone (501) 392-9065

2425 Dave Ward Dr
Ste 302
Conway, AR 72034

148 Sawtooth Oak St
Hot Springs National Park, AR 71901
Phone (501) 346-8116

108 N Shackleford Rd
Little Rock, AR 72211
Phone (501) 346-8116

9 Freeway Dr
Little Rock, AR 72204
Phone (501) 280-0707

4020 Richards Rd
Ste A
North Little Rock, AR 72117
Phone (501) 900-8763

Organizations & group practices 4

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 8

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

NPI Registry JSON

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1346620697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N SHACKLEFORD RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722112840",
            "telephone_number": "586-488-8464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 N SHACKLEFORD RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722112840",
            "telephone_number": "844-215-8731",
            "fax_number": "888-630-8885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 St. Antoine St",
            "address_2": "9C-UHC",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "48201",
            "country_code": "US",
            "telephone_number": "313-745-5146 x5147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALKI",
        "first_name": "BRIAN",
        "middle_name": "IBRAHIM",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-02",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "E13184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "E-13184",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.