NPIMap

Individual provider Active NPI

Shahid Q Mallick, M.D.

  • Pulmonary Disease Physician
  • Sugar Land, TX
National Provider Identifier
1396738415
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
J8042 Issued in TX
Practice address
3511 Town Center Blvd S
Suite #102
Sugar Land, TX 77479-1285
Phone
(281) 491-1185
Fax
(281) 491-1247
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X J8042 TX Primary

Addresses

Primary practice location

3511 Town Center Blvd S
Suite #102
Sugar Land, TX 77479-1285

Mailing address

3511 Town Center Blvd S
Suite #102
Sugar Land, TX 77479-1285
Phone (281) 491-1185

Other identifiers 1

IdentifierTypeStateIssuer
122372903MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20041215000372 TX Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists)Practitioner - Other (Physician) 9436116001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3511 Town Ctr Blvd S
Suite 102
Sugar Land, TX 77479-1464
Phone (281) 491-1185

3811 Town Ctr Blvd S
Suite 102
Sugar Land, TX 77479-1464

Hospital & facility affiliations

  • Houston Methodist Sugarland Hospital Hospital, Sugar Land, TX, CCN 450820
  • St Luke'S Sugar Land Hospital Hospital, Sugar Land, TX, CCN 670053
  • Sugar Land Surgical Hospital LLP Hospital, Sugar Land, TX, CCN 450860
  • Memorial Hermann Sugar Land Hospital Hospital, Sugar Land, TX, CCN 450848
  • Memorial Hermann Hospital System Hospital, Houston, TX, CCN 450184

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
J8042TXMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shahid Mallick MD PA Sweetwater Pulmonary & Sleep Disorder Center Pulmonary Disease CurrentSince Nov 20, 2006 Accepting new patients
South Texas Medical Clinics, P.a. Past Accepting new patients
CCC - Critical Care Consultants Past Accepting new patients
South Texas Medical Clinics, P.a. Past Accepting new patients

Locations

7777 Southwest Fwy
Ste 640
Houston, TX 77074
Phone (713) 270-0477

3511 Town Center Blvd S
Ste 102
Sugar Land, TX 77479
Phone (281) 325-1005

Interoperability endpoints

  • Direct secure messaging: smallick@direct.uspi.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/CBDABA/Endpoint/CBDABA

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 10

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1396738415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3511 TOWN CENTER BLVD S",
            "address_2": "SUITE #102",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774791285",
            "telephone_number": "281-491-1185",
            "fax_number": "281-491-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3511 TOWN CENTER BLVD S",
            "address_2": "SUITE #102",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774791285",
            "telephone_number": "281-491-1185",
            "fax_number": "281-491-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLICK",
        "first_name": "SHAHID",
        "middle_name": "Q",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "J8042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122372903",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.