Individual provider Active NPI

Mounica Sai Malyala, MBBS, MD

  • Hospitalist Physician
  • Woodland, CA
National Provider Identifier
1417535170
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
A195365 Issued in CA
Practice address
632 W Gibson Rd
Woodland, CA 95695-5169
Phone
(530) 668-2600
Fax
(530) 661-0880
NPI assigned
Apr 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X A195365 CA Primary

Addresses

Primary practice location

632 W Gibson Rd
Woodland, CA 95695-5169

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956
Phone (916) 851-2462

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240925002977 CA Practitioner - Hospitalist 0143761528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

632 W Gibson Rd
Woodland, CA 95695-5169
Phone (530) 668-2600

Hospital & facility affiliations

  • Woodland Memorial Hospital Hospital, Woodland, CA, CCN 050127

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince Sep 3, 2024 Accepting new patients
Dignity Health Medical Foundation CurrentSince Sep 3, 2024 Accepting new patients
Dignity Health Medical Foundation Current Accepting new patients

Locations

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

632 W Gibson Rd
Woodland, CA 95695
Phone (530) 666-1631

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 1

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": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1417535170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956",
            "telephone_number": "916-851-2462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 W GIBSON RD",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956955169",
            "telephone_number": "530-668-2600",
            "fax_number": "530-661-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALYALA",
        "first_name": "MOUNICA",
        "middle_name": "SAI",
        "credential": "MBBS, MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-01",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A195365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland, CA

Sources for this page

Verify at the official NPI Registry.