NPIMap

Individual provider Active NPI

Amir A Malik, MD

  • Internal Medicine Physician
  • St Augustine, FL
National Provider Identifier
1386749505
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME50791 Issued in FL
Practice address
204 Southpark Cir E
St Augustine, FL 32086-5135
Phone
(904) 829-8300
Fax
(904) 829-8310
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME50791 FL
Internal Medicine Physician 207R00000X ME50791 FL Primary

Addresses

Primary practice location

204 Southpark Cir E
St Augustine, FL 32086-5135

Mailing address

PO Box 1779
St Augustine, FL 32085-1779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100308000521 FL Practitioner - Internal MedicinePractitioner - Nephrology 6507883345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amir a Malik MD PAGroup PAC ID 4981621729, 4 clinicians

Practice addresses (Care Compare)

204 Southpark E Cir
Saint Augustine, FL 32086-5135
Phone (904) 829-8300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME50791FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amir a Malik MD PA Nephrology CurrentSince Jun 8, 1987 Accepting new patients
Vijayselwyn Davis Dhas MD Past Accepting new patients

Locations

199 S US Highway 17
#C
East Palatka, FL 32131
Phone (386) 312-0556

264 Palm Coast Pkwy NE
Palm Coast, FL 32137
Phone (386) 246-5075

204 Southpark Cir E
St Augustine, FL 32086
Phone (904) 829-8300

Interoperability endpoints

  • Direct secure messaging: amalik743892@direct.shands.ufl.edu
  • Direct secure messaging: amirmalik@aammdpa.allscriptsdirect.net

Organizations & group practices 3

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 7

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1386749505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1779",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320851779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 SOUTHPARK CIR E",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865135",
            "telephone_number": "904-829-8300",
            "fax_number": "904-829-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIK",
        "first_name": "AMIR",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME50791",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME50791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.