Individual provider Active NPI

Mammen Maliakkal, MD

  • Internal Medicine Physician
  • Eagle Pass, TX
National Provider Identifier
1497730816
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
N7455 Issued in TX
Practice address
3333 N Foster Maldonado Blvd
Eagle Pass, TX 78852-5893
Phone
(830) 773-5321
NPI assigned
Dec 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X N7455 TX Primary
Hospitalist Physician 208M00000X N7455 TX

Addresses

Primary practice location

3333 N Foster Maldonado Blvd
Eagle Pass, TX 78852-5893

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-4997

Other practice location 1

2727 W Holcombe Blvd
Houston, TX 77025-1669
Phone (713) 442-0000

Other identifiers 3

IdentifierTypeStateIssuer
N371170OtherFLWELLCARE
14025OtherFLBLUE CROSS BLUE SHIELD
278190500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA, GU3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20110218000791 TX Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Pediatric Medicine 5092743104 Reassigns benefits to 7 organizations
I20190228000800 CA Practitioner - HospitalistPractitioner - Internal Medicine 5092743104 Reassigns benefits to 2 organizations
I20210512003392 GU Practitioner - Internal MedicinePractitioner - Hospitalist 5092743104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.4 of 100Reported as group
Quality
65.6
Improvement activities
40
Cost
71.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N7455TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Galen Inpatient Physicians, PC Hospitalist Current Accepting new patients
Cogent Healthcare of Texas, PA Internal Medicine CurrentSince Feb 1, 2019 Accepting new patients
Guam Memorial Hospital CurrentSince Jan 6, 2021 Accepting new patients
Galen Inpatient Physicians PC Hospitalist CurrentSince Sep 15, 2023 Accepting new patients
Lonestar Hospital Medicine Associates, PA Internal Medicine CurrentSince May 1, 2023 Accepting new patients
Pacific Redwood Medical Group Inc Internal Medicine CurrentSince Jan 1, 2019 Accepting new patients
Galen Inpatient Physicians, PC Hospitalist CurrentSince Sep 15, 2023 Accepting new patients
Guam Memorial Hospital CurrentSince Jan 6, 2021 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Oct 26, 2020 Accepting new patients
Kelsey-Seybold Medical Group, PLLC Internal Medicine CurrentSince Jan 3, 2022 Accepting new patients
Southwest Medical Associates, Inc. CurrentSince Sep 1, 2017 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Sep 1, 2017 Accepting new patients
Concord Medical Group PLLC CurrentSince Oct 26, 2020 Accepting new patients
Vejovis Health Internal Medicine PastSince Nov 21, 2011 Accepting new patients
Hospital Internists of Austin, P.a. Past Accepting new patients

Locations

700 River Dr
Fort Bragg, CA 95437
Phone (707) 961-1234

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

869 N Cherry St
Tulare, CA 93274
Phone (559) 326-2800

275 Hospital Dr
Ukiah, CA 95482
Phone (707) 462-7900

15248 Eleventh St
Victorville, CA 92395
Phone (760) 245-8691

1 Marcela Dr
Willits, CA 95490
Phone (707) 456-3001

850 Gov Carlos G Camacho Rd
#R
Tamuning, GU 96913
Phone (671) 647-2552

1201 W 38th St
Austin, TX 78705
Phone (512) 324-1058

7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305

601 E 15th St
Austin, TX 78701
Phone (512) 324-7868

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

3201 W State Highway 22
Corsicana, TX 75110
Phone (903) 654-6800

1416 George Dieter Dr
El Paso, TX 79936
Phone (877) 822-6281

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

201 Enterprise Ave
Ste 900
League City, TX 77573
Phone (713) 442-2826

1201 E Highway 287
Midlothian, TX 76065
Phone (469) 695-2065

7010 Highway 6
Missouri City, TX 77459
Phone (713) 442-4200

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

2515 Business Center Dr
Pearland, TX 77584
Phone (713) 442-7200

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

201 Seton Pkwy
Round Rock, TX 78665
Phone (512) 324-1010

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1497730816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 N FOSTER MALDONADO BLVD",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788525893",
            "telephone_number": "830-773-5321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2727 W Holcombe Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770251669",
            "country_code": "US",
            "telephone_number": "713-442-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALIAKKAL",
        "first_name": "MAMMEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N7455",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "N7455",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "N371170",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "14025",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278190500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Pass, TX

Sources for this page

Verify at the official NPI Registry.