NPIMap

Individual provider Active NPI

Imran Mushtaq Malik, M.D.

  • Family Medicine Physician
  • Port St Lucie, FL
National Provider Identifier
1760651285
Registry record updated Nov 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME107296 Issued in FL
Practice address
8515 S US Highway 1
Suite 3
Port St Lucie, FL 34952-3346
Phone
(772) 380-4042
Fax
(772) 380-4043
NPI assigned
Feb 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301090215 MI
Family Medicine Physician 207Q00000X ME107296 FL Primary

Addresses

Primary practice location

8515 S US Highway 1
Suite 3
Port St Lucie, FL 34952-3346

Mailing address

8515 S US Highway 1
Suite 3
Port St Lucie, FL 34952-3346
Phone (772) 380-4042

Other identifiers 1

IdentifierTypeStateIssuer
003235300MedicaidFL

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
I20110114000722 FL Practitioner - Family Practice 1355530775 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8515 S US Hwy 1
Suite 3
Port Saint Lucie, FL 34952-3346
Phone (772) 380-4042

Hospital & facility affiliations

  • HCA Florida Healthcare at Home Home health agency, Fort Pierce, FL, CCN 107271
  • Pinnacle Home Care Home health agency, Port Saint Lucie, FL, CCN 109610
  • Vitalcaring Group Home health agency, West Palm Beach, FL, CCN 108331
  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545
  • HCA Florida Lawnwood Hospital Hospital, Fort Pierce, FL, CCN 100246
  • Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044
  • St Lucie Medical Center Hospital, Port Saint Lucie, FL, CCN 100260
  • HCA Florida Raulerson Hospital Hospital, Okeechobee, FL, CCN 100252
  • HCA Florida Highlands Hospital Hospital, Sebring, FL, CCN 100049
  • Solaris Healthcare Parkway Nursing home, Stuart, FL, CCN 105687
  • Tiffany Hall Nursing and Rehab Center Nursing home, Port Saint Lucie, FL, CCN 105819
  • Palm Garden of Port Saint Lucie Nursing home, Port Saint Lucie, FL, CCN 105600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301090215MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Treasure Coast Palliative Care, LLC CurrentSince Jul 18, 2022 Accepting new patients
Raulerson Primary Care LLC PastSince Nov 16, 2015 Accepting new patients

Locations

5000 NW Dunn Rd
Fort Pierce, FL 34981
Phone (772) 403-4500

1201 SE Indian St
Stuart, FL 34997
Phone (772) 403-4500

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DEIHAD/Endpoint/DEIHAD

Organizations & group practices 3

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321315200000",
    "number": "1760651285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8515 S US HIGHWAY 1",
            "address_2": "SUITE 3",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349523346",
            "telephone_number": "772-380-4042",
            "fax_number": "772-380-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8515 S US HIGHWAY 1",
            "address_2": "SUITE 3",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349523346",
            "telephone_number": "772-380-4042",
            "fax_number": "772-380-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIK",
        "first_name": "IMRAN",
        "middle_name": "MUSHTAQ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-28",
        "last_updated": "2011-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301090215",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME107296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003235300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.