Individual provider Active NPI

Nitin Gulshan Malhotra, MD

  • Vascular Surgery Physician
  • Belleville, IL
National Provider Identifier
1407007982
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
NM095825 Issued in MI
Practice address
4600 Memorial Dr Ste 120
Belleville, IL 62226-5359
Phone
(618) 222-1020
Fax
(618) 222-1039
NPI assigned
Oct 2, 2008
Last updated
Feb 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X NM095825 MI Primary
Vascular Surgery Physician 2086S0129X 036177465 IL

Addresses

Primary practice location

4600 Memorial Dr Ste 120
Belleville, IL 62226-5359

Mailing address

5020 W Bristol Rd
Flint, MI 48507-2919
Phone (810) 732-1620

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2 Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101012001010 MI Practitioner - Vascular Surgery 2769674563 Reassigns benefits to 1 organization
I20260409000234 IL Practitioner - Vascular Surgery 2769674563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians
Vascular Surgery Assoc PCGroup PAC ID 2567443559, 16 clinicians

Practice addresses (Care Compare)

1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7240

4500 Memorial Dr
Belleville, IL 62226-5360
Phone (618) 257-6220

5020 W Bristol Rd
Flint, MI 48507-2919
Phone (810) 732-1620

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Leg revascularization (restoring blood flow)32
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036177465ILMDVascular Surgery Physician
NM095825MIMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vascular Surgery Assoc PC Vascular Surgery CurrentSince Jul 1, 2010 Accepting new patients
Vascular Surgery Assoc, PC Vascular Surgery Past Accepting new patients
Vascular Surgery Assoc, PC Vascular Surgery Past Accepting new patients
McLaren Flint Past Accepting new patients

Locations

5701 Bow Pointe Dr
Ste 210
Clarkston, MI 48346
Phone (248) 384-8201

5020 W Bristol Rd
Flint, MI 48507
Phone (313) 732-1620

5054 W Bristol Rd
Ste E
Flint, MI 48507
Phone (810) 600-2030

5151 Gateway Ctr
Ste 400
Flint, MI 48507
Phone (810) 230-4532

5202 Miller Rd
Ste B
Flint, MI 48507
Phone (810) 720-1600

1122 S Lapeer Rd
Ste C
Lapeer, MI 48446
Phone (810) 272-3880

4700 McLeod Dr E
Ste A
Saginaw, MI 48604
Phone (989) 791-4652

Interoperability endpoints

  • Direct secure messaging: nitinmalhotra@mvc.allscriptsdirect.net
  • Direct secure messaging: nmalhotra1139942@direct.hfhs.org

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1222905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1407007982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5020 W BRISTOL RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485072919",
            "telephone_number": "810-732-1620",
            "fax_number": "810-732-8559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 MEMORIAL DR STE 120",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265359",
            "telephone_number": "618-222-1020",
            "fax_number": "618-222-1039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALHOTRA",
        "first_name": "NITIN",
        "middle_name": "GULSHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-02",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "NM095825",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "036177465",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4600 Memorial Dr Ste 120",
            "city": "Belleville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622265359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.