Individual provider Active NPI

Prerana Malla, MD

  • Pediatrics Physician
  • Atlanta, GA
National Provider Identifier
1508325309
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
104150 Issued in GA
Practice address
1001 Johnson Fy Rd NE
Atlanta, GA 30342-1605
Phone
(404) 785-5437
NPI assigned
Mar 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 104150 GA Primary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 104150 GA
Pediatrics Physician 208000000X T7294 TX
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1001 Johnson Fy Rd NE
Atlanta, GA 30342-1605

Mailing address

PO Box 422002
Atlanta, GA 30342-9002
Phone (404) 907-4242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, GA2 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
I20220917000441 TX Practitioner - Pediatric Medicine 3971988544 Reassigns benefits to 1 organization
I20250930002110 GA Practitioner - Pediatric Medicine 3971988544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1643 NW 136 Ave
Sunrise, FL 33323-2857

4232 Perimeter Park E
Atlanta, GA 30341-1366

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage, LLC CurrentSince Sep 1, 2025 Accepting new patients
Travis County Emergency Physicians PA CurrentSince Sep 1, 2022 Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

1001 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 785-2008

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

2615 Southwest Fwy
Ste 140
Houston, TX 77098
Phone (713) 441-2779

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

1310 E League City Pkwy
League City, TX 77573
Phone (346) 427-5050

11525 Broadway St
Pearland, TX 77584
Phone (713) 363-8020

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1508325309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 422002",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303429002",
            "telephone_number": "404-907-4242",
            "fax_number": "404-842-3479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 JOHNSON FY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421605",
            "telephone_number": "404-785-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLA",
        "first_name": "PRERANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "104150",
            "primary": true
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "GA",
            "license": "104150",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "T7294",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.