NPIMap

Individual provider Active NPI

Malka Merav Bannet, D.O.

  • Internal Medicine Physician
  • Livingston, NJ
National Provider Identifier
1639467756
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MB10390000 Issued in NJ
Practice address
75 E Northfield Rd
Livingston, NJ 07039-4532
Phone
(973) 436-1460
Fax
(973) 422-9390
NPI assigned
Jul 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2019

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 276073-1 NY
Internal Medicine Physician 207R00000X 25MB10390000 NJ Primary

Addresses

Primary practice location

75 E Northfield Rd
Livingston, NJ 07039-4532

Mailing address

1111 Amsterdam Ave
New York, NY 10025-1716

Other identifiers 1

IdentifierTypeStateIssuer
00122324700MedicaidNY

Other names 1

  • Malka Merav Abraham Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150326000344 NY Practitioner - Internal Medicine 8426375734 Reassigns benefits to 2 organizations
I20211103003298 OH Practitioner - Internal Medicine 8426375734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Touro Un Col of Osteopathic Medicine, New York, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Primary Care Practices IncGroup PAC ID 3072417534, 1,071 clinicians

Practice addresses (Care Compare)

158 W Main Rd
Conneaut, OH 44030-2039

3909 Orange PL
Beachwood, OH 44122-4468
Phone (216) 383-0100

Hospital & facility affiliations

  • University Hospital Home Care Services, Inc Home health agency, Warrensville HTS, OH, CCN 367424
  • Uh Cleveland Medical Center Hospital, Cleveland, OH, CCN 360137
  • University Hospitals Ahuja Medical Center Hospital, Beachwood, OH, CCN 360359
  • Lake Health Hospital, Concord, OH, CCN 360098

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB10390000NJMDInternal Medicine Physician
276073-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc Internal Medicine CurrentSince Nov 15, 2021 Accepting new patients
William F Ryan Community Health Center Inc CurrentSince Feb 17, 2015 Accepting new patients
Icahn School of Medicine at Mount Sinai Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients
University Primary Care Practices Inc Current Accepting new patients
University Primary Care Practices Inc CurrentSince Nov 15, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
William F Ryan Community Health Center Inc CurrentSince Feb 17, 2015 Accepting new patients
University Primary Care Practices Past Accepting new patients

Locations

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

110 W 97th St
New York, NY 10025
Phone (212) 316-7906

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

3909 Orange Pl
Ste 2400
Beachwood, OH 44122
Phone (216) 464-1115

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

Interoperability endpoints

  • Direct secure messaging: mbannet36106@ehrdirect.uhhospitals.org

Organizations & group practices 9

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 7

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": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1639467756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 E NORTHFIELD RD",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394532",
            "telephone_number": "973-436-1460",
            "fax_number": "973-422-9390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNET",
        "first_name": "MALKA",
        "middle_name": "MERAV",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-11",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "276073-1",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB10390000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00122324700",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALKA",
            "last_name": "ABRAHAM",
            "middle_name": "MERAV",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Livingston, NJ

Sources for this page

Verify at the official NPI Registry.