Mallory Christine Nagarah, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

5101019837 Issued in MI

Practice address

15675 Northline Rd
Southgate, MI 48195-2334

Phone

(734) 282-3600

Fax

(734) 282-3603

NPI assigned

Mar 19, 2012

Last updated

Feb 22, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

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 1

Specialty

Obstetrics/Gynecology

Education

Michigan State University College of Osteopathic Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Wyandotte HospitalGroup PAC ID 2264334499, 194 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wyandotte Hospital and Medical Center Hospital, Wyandotte, MI, CCN 230146

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mnagarah60147@direct.hfhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Henry Ford Wyandotte Hospital

  • Obstetrics & Gynecology Physician
  • Wyandotte, MI
  • NPI 1457586646
  Medicare reassignment Care Compare group NPD
• Henry Ford Wyandotte Hospital

  dba Henry Ford Health Center-Brownstown Pharmacy

  • Community/Retail Pharmacy
  • Brownstown TWP, MI
  • NPI 1356356984
  NPD
• Henry Ford Wyandotte Hospital

  • Certified Registered Nurse Anesthetist
  • Wyandotte, MI
  • NPI 1386685212
  NPD (past)
• Henry Ford Wyandotte Hospital

  • General Acute Care Hospital
  • Wyandotte, MI
  • NPI 1992725352
  NPD (past)
• Munther Alaiwat, M.D. , P.C.

  dba Northline Women's Health Center

  • Obstetrics & Gynecology Physician
  • Southgate, MI
  • NPI 1861688780
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Wyandotte Hospital

  dba Henry Ford Health Center Brownstown

  • Ambulatory Surgical Clinic/Center
  • Wyandotte, MI
  • NPI 1093901035

  Hospital

  Care Compare affiliation
• Henry Ford Wyandotte Hospital

  • General Acute Care Hospital
  • Wyandotte, MI
  • NPI 1992725352
  Care Compare affiliation

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1740555002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 FORT ST SUITE D",
            "address_2": "ATTN DENISE",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "48183",
            "telephone_number": "734-391-3057",
            "fax_number": "734-391-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15675 NORTHLINE RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952334",
            "telephone_number": "734-282-3600",
            "fax_number": "734-282-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGARAH",
        "first_name": "MALLORY",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-19",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101019837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI HENRY FORD WYANDOTTE",
            "identifier": "1457586646",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0H24657",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Myeyedr Optometry of Michigan, LLC (RX Optical)
• Warner Myntti
• Desire N'Cho
• Mona Nabha
• Champa Nagappa, MD
• Nassrine Naim, DO
• Anna Maria Napolitano, AT, ATC
• Emily Nicole Nash
• Abbey Nicole Naso
• Reem Nasr

• Obstetrics & Gynecology Physician in Southgate, MI
• Providers in Southgate, MI by specialty
• Obstetrics & Gynecology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.