NPIMap

Individual provider Active NPI

Azhar A Malik, M.D

  • Nephrology Physician
  • Temple Terrace, FL
National Provider Identifier
1609872670
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME82487 Issued in FL
Practice address
12662 Telecom Dr
Temple Terrace, FL 33637-0935
Phone
(813) 910-0030
Fax
(813) 971-6473
NPI assigned
Jun 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME82487 FL
Nephrology Physician 207RN0300X ME82487 FL Primary

Addresses

Primary practice location

12662 Telecom Dr
Temple Terrace, FL 33637-0935

Mailing address

511 Medical Oaks Ave
Brandon, FL 33511-5961
Phone (813) 681-8212

Other identifiers 1

IdentifierTypeStateIssuer
264136400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120220000576 FL Practitioner - Nephrology 9739347949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Kidney Physicians LLCGroup PAC ID 4385925650, 167 clinicians

Practice addresses (Care Compare)

3140 S Falkenburg Rd
Suite 201
Riverview, FL 33578-2594
Phone (813) 910-0030

Hospital & facility affiliations

  • DaVita Plant City Dialysis Dialysis facility, Plant City, FL, CCN 102554
  • DaVita Falkenburg Dialysis Dialysis facility, Riverview, FL, CCN 682630
  • DaVita Fishhawk Dialysis Dialysis facility, Lithia, FL, CCN 682796
  • HCA Florida Brandon Hospital Hospital, Brandon, FL, CCN 100243
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075
  • South Florida Baptist Hospital Hospital, Plant City, FL, CCN 100132
  • HCA Florida South Shore Hospital Hospital, Sun City Center, FL, CCN 100259
  • Adventhealth Riverview Hospital, Riverview, FL, CCN 100364

Merit-based Incentive Payment System (MIPS)

Final score
89.8 of 100Reported as individual
Quality
69.53
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME82487FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Kidney Physicians, LLC Nephrology CurrentSince Oct 11, 2016 Accepting new patients
Florida Kidney Physicians , LLC Nephrology CurrentSince Oct 11, 2016 Accepting new patients

Locations

511 Medical Oaks Ave
Brandon, FL 33511
Phone (813) 681-8212

2501 Paul Buchman Hwy
Ste A
Plant City, FL 33563

3140 S Falkenburg Rd
Ste 201
Riverview, FL 33578

12662 Telecom Dr
Temple Terrace, FL 33637
Phone (813) 910-8708

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: azhar.malik.1@15644.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/15644/brand/1/csg/1/fhir/r4

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.

Hospital & facility affiliations 9

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": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1609872670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 MEDICAL OAKS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115961",
            "telephone_number": "813-681-8212",
            "fax_number": "813-654-0478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12662 TELECOM DR",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370935",
            "telephone_number": "813-910-0030",
            "fax_number": "813-971-6473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIK",
        "first_name": "AZHAR",
        "middle_name": "A",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME82487",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME82487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264136400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Terrace, FL

Sources for this page

Verify at the official NPI Registry.