Active NPI
Malik Asad Anjum, M.D.
- Nephrology Physician
- Norfolk, VA
National Provider Identifier
1386902104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 0101262154
- Practice address
- 301 Riverview Ave Ste 512
Norfolk, VA 23510 - Phone
- (757) 623-0005
- Fax
- (757) 389-5774
- NPI assigned
- Apr 30, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 0101262154 | VA | Primary |
Addresses
Primary practice location
301 Riverview Ave Ste 512
Norfolk, VA 23510
Mailing address
4445 Corporation LN Ste 100
Virginia Beach, VA 23462-3666
Phone (757) 623-0005
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170822002425 | VA | Practitioner - Nephrology | 4082986302 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Tidewater Kidney Specialists Inc
Practice addresses (Care Compare)
500 W 21St St
Suite 102
Norfolk, VA 23517-1955
Phone (757) 623-0005
Hospital & facility affiliations
- DaVita Tidewater Home Dialysis
- DaVita Little Creek Dialysis
- Sentara Norfolk General Hospital
- Sentara Virginia Beach General Hospital
- Sentara Princess Anne Hospital
- Sentara Obici Hospital
- Sentara Leigh Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tidewater Kidney Specialists, Inc. | Single Specialty | Current | Accepting new patients |
| Tidewater Kidney Specialists, Inc. | Single Specialty | Current | Accepting new patients |
Locations
814 Kempsville Rd
Ste 102
Norfolk, VA 23502
500 W 21st St
Ste 102
Norfolk, VA 23517
301 Riverview Ave
Ste 512
Norfolk, VA 23510
Phone (757) 627-5116
4445 Corporation Ln
Ste 100
Virginia Beach, VA 23462
4560 South Blvd
Ste 202
Virginia Beach, VA 23452
Phone (757) 340-6100
Interoperability endpoints
- malikanjum@tks.allscriptsdirect.net
Organizations & group practices 2
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.
-
- Nephrology Physician
- Virginia Beach, VA
- NPI 1780624627
Single Specialty, VA
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Virginia Beach, VA
- NPI 1609110758
Dialysis facility
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Norfolk, VA
- NPI 1699034686
Dialysis facility
-
- General Acute Care Hospital
- Virginia Beach, VA
- NPI 1528028396
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642636800000",
"number": "1386902104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4445 CORPORATION LN STE 100",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234623666",
"telephone_number": "757-623-0005",
"fax_number": "757-548-1129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 RIVERVIEW AVE STE 512",
"city": "NORFOLK",
"state": "VA",
"postal_code": "23510",
"telephone_number": "757-623-0005",
"fax_number": "757-389-5774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANJUM",
"first_name": "MALIK",
"middle_name": "ASAD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-04-30",
"last_updated": "2022-01-20",
"certification_date": "2022-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Nephrology",
"state": "VA",
"license": "0101262154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norfolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; 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.