Raju Malla

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C07538 Issued in MD

Practice address

461 Clinton St Ext # 1
Schenectady, NY 12305-2425

Phone

(518) 374-7222

NPI assigned

Apr 17, 2019

Last updated

Jul 18, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, MD2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Upstate Dermatology, PCGroup PAC ID 3375434046, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Marys Healthcare Hospital, Amsterdam, NY, CCN 330047
• Ellis Hospital Hospital, Schenectady, NY, CCN 330153

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Upstate Dermatology, PC

  • Dermatology Physician
  • Castleton, NY
  • NPI 1609826163
  Medicare reassignment Care Compare group
• Cep America LLC

  dba Vituity

  • Emergency Medicine Physician
  • Baltimore, MD
  • NPI 1821434002
  Medicare reassignment
• Cep America LLC

  • Emergency Medicine Physician
  • Towson, MD
  • NPI 1093591570
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD

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

• Ellis Hospital

  • General Acute Care Hospital
  • Schenectady, NY
  • NPI 1487644993
  Care Compare affiliation
• St. Mary's Healthcare

  • General Acute Care Hospital
  • Amsterdam, NY
  • NPI 1811977796
  Care Compare affiliation

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1477116176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2A RED MAPLE LN",
            "city": "HALFMOON",
            "state": "NY",
            "postal_code": "120656340",
            "telephone_number": "443-682-4902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 CLINTON ST EXT # 1",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123052425",
            "telephone_number": "518-374-7222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "532 N Central Ave Apt 7",
            "address_purpose": "LOCATION",
            "city": "Minoa",
            "state": "NY",
            "postal_code": "131161458",
            "country_code": "US",
            "telephone_number": "443-682-4902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLA",
        "first_name": "RAJU",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-17",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C07538",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meena Makhijani, D.D.S.
• Anthony L. Malanga, MD
• Jay V Malde, M.D.
• Hina Malik, MD
• Valerie Malivuk, LMHC
• Alyssa L Malone, MSED., CCC-SLP
• Molly Anne Malone, LCSW
• Jory A Maloney, RDH
• Katherine Maloney, LPN
• Kerri E Maloney, DPT

• Physician Assistant in Schenectady, NY
• Providers in Schenectady, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.

Verify at the official NPI Registry.