Individual provider Active NPI

Rajiv Matthew Mallipudi, M.D.

  • Hospitalist Physician
  • Bridgeport, CT
National Provider Identifier
1760845747
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
62105 Issued in CT
Practice address
267 Grant St
Bridgeport, CT 06610
Phone
(203) 384-4677
Fax
(203) 384-3135
NPI assigned
Mar 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 62105 CT
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X 62105 CT Primary

Addresses

Primary practice location

267 Grant St
Bridgeport, CT 06610

Mailing address

20 York Street, CB-2041
New Haven, CT 06510-3220
Phone (203) 384-4677

Other practice location 1

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-4677

Other practice location 2

1 Bay Ave
Mountainside Hospital
Montclair, NJ 07042-4837
Phone (973) 429-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190617001404 CT Practitioner - Hospitalist 0446583942 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

267 Grant St
Bridgeport, CT 06610-2805
Phone (203) 384-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.02 of 100Reported as group
Quality
87.5
Promoting interoperability
100
Improvement activities
40
Cost
77.51

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Connecticut, LLC Internal Medicine CurrentSince Mar 1, 2020 Accepting new patients
Bridgeport Hospital CurrentSince Feb 1, 2020 Accepting new patients
Northeast Medical Group, Inc. Internal Medicine CurrentSince Jul 1, 2019 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Jan 1, 2021 Accepting new patients
Bridgeport Hospital CurrentSince Feb 1, 2020 Accepting new patients

Locations

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981

300 Seaside Ave
Milford, CT 06460
Phone (203) 876-4000

20 York St
#2041
North Haven, CT 06510
Phone (203) 688-1734

175 Capital Blvd
Fl 4
Rocky Hill, CT 06067
Phone (860) 380-0452

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: rmallipudi429590@direct.ynhh.org

Organizations & group practices 5

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 3

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": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1760845747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK STREET, CB-2041",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-384-4677",
            "fax_number": "203-384-3135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 GRANT ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06610",
            "telephone_number": "203-384-4677",
            "fax_number": "203-384-3135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "267 Grant St",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "CT",
            "postal_code": "06610",
            "country_code": "US",
            "telephone_number": "203-384-4677",
            "fax_number": "203-384-3135",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Bay Ave",
            "address_2": "Mountainside Hospital",
            "address_purpose": "LOCATION",
            "city": "Montclair",
            "state": "NJ",
            "postal_code": "070424837",
            "country_code": "US",
            "telephone_number": "973-429-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLIPUDI",
        "first_name": "RAJIV",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-29",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "62105",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "62105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.