Faryal Shahab Malick, MD

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

MD27513 Issued in ME

Practice address

417 State St Ste 20
Bangor, ME 04401-6637

Phone

(207) 973-9185

NPI assigned

Jun 22, 2018

Reactivated

Jul 3, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

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 1

Specialty

Critical Care (Intensivists)

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eastern Maine Medical CenterGroup PAC ID 2062315161, 659 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033
• St Joseph Hospital Hospital, Bangor, ME, CCN 200001
• Northern Light Maine Coast Hospital Hospital, Ellsworth, ME, CCN 200050
• Northern Light Mayo Hospital Hospital, Dover Foxcroft, ME, CCN 201309
• Northern Light Sebasticook Valley Hospital Hospital, Pittsfield, ME, CCN 201313

Merit-based Incentive Payment System (MIPS)

Final score

84.1 of 100Reported as group

Quality

64.8

Promoting interoperability

96

Improvement activities

40

Cost

68.87

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Eastern Maine Medical Center

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1790789147
  Medicare reassignment Care Compare group NPD
• Eastern Maine Medical Center

  • Rehabilitation Hospital Unit
  • Bangor, ME
  • NPI 1780674689
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Eastern Maine Medical Center

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1790789147
  Care Compare affiliation
• Maine Coast Regional Health Facilities

  • General Acute Care Hospital
  • Ellsworth, ME
  • NPI 1740249739
  Care Compare affiliation
• MRH Corp.

  • Critical Access Hospital
  • Dover Foxcroft, ME
  • NPI 1558319103
  Care Compare affiliation
• Sebasticook Valley Health

  • Critical Access Hospital
  • Pittsfield, ME
  • NPI 1457461477
  Care Compare affiliation
• St. Joseph Hospital

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1154321545
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1467947473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 STATE ST STE 20",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016637",
            "telephone_number": "207-973-9185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 STATE ST STE 20",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016637",
            "telephone_number": "207-973-9185"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "VCUHS Dept of Internal Medicine Residency, 980509",
            "address_2": "1250 E. Marshall Street",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232980510",
            "country_code": "US",
            "telephone_number": "804-828-5161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 Stantonsburg Road",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "27834",
            "country_code": "US",
            "telephone_number": "252-847-2658",
            "fax_number": "252-847-8304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALICK",
        "first_name": "FARYAL",
        "middle_name": "SHAHAB",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-22",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "deactivation_date": "2019-06-26",
        "reactivation_date": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116033420",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "ME",
            "license": "MD27513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael William Mainen, M.D.
• Manmeet Makhni, M.D.
• Making the Impossible Possible Case Management
• Devon Courtney Malay, APRN
• Albaluz Malcolm
• Mallick Endodontics
• Nikhil S Mallick, DDS
• Norman Robert Mallory, PA-C
• Bruce A Malmer, M.D.
• Teresa Tolson Malmer, MD

• Critical Care Medicine (Internal Medicine) Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Critical Care Medicine (Internal Medicine) Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.

Verify at the official NPI Registry.