NPIMap

Individual provider Active NPI

Maryam Malik

  • Internal Medicine Physician
  • Cheverly, MD
National Provider Identifier
1518490671
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
12128 Issued in SD
Practice address
3001 Hospital Dr
Cheverly, MD 20785-1189
Phone
(301) 618-3776
Fax
(301) 618-2986
NPI assigned
Apr 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 12128 SD Primary

Addresses

Primary practice location

3001 Hospital Dr
Cheverly, MD 20785-1189

Mailing address

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200922002755 SD Practitioner - Internal Medicine 2567880644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital Inc CurrentSince Sep 1, 2020 Accepting new patients
Monument Health Rapid City Hospital, Inc. Family Medicine CurrentSince Sep 1, 2020 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Monument Health Rapid City Hospital, Inc. Past Accepting new patients

Locations

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

Organizations & group practices 4

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 12

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": "1491436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1518490671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 FAIRMONT BLVD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577017375",
            "telephone_number": "605-755-1000",
            "fax_number": "301-618-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 HOSPITAL DR",
            "city": "CHEVERLY",
            "state": "MD",
            "postal_code": "207851189",
            "telephone_number": "301-618-3776",
            "fax_number": "301-618-2986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIK",
        "first_name": "MARYAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-06",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SD",
            "license": "12128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheverly, MD

Sources for this page

Verify at the official NPI Registry.