NPIMap

Individual provider Active NPI

Prakash Malviya, MD

  • Pediatrics Physician
  • Carthage, TX
National Provider Identifier
1770666208
Registry record updated Mar 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
189949 Issued in NY
Practice address
409 Cottage Road
Etmc
Carthage, TX 75633
Phone
(903) 694-4790
NPI assigned
Oct 20, 2006
Last updated
Mar 11, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 189949 NY Primary

Addresses

Primary practice location

409 Cottage Road
Etmc
Carthage, TX 75633

Mailing address

409 Cottage Road
Etmc
Carthage, TX 75633
Phone (903) 694-4790

Other identifiers 2

IdentifierTypeStateIssuer
CAREPLUSOtherNY189949
01553277MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CMC Housestaff Past Accepting new patients
CMC Radiological Services PC Past Accepting new patients
Caritas Emergency Medical Services, PC Past Accepting new patients
CMC Radiological Services PC Past Accepting new patients
Sabine County Hospital District Past Accepting new patients
Caritas Emergency Medical Services, PC Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299801600000",
    "number": "1770666208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 COTTAGE ROAD",
            "address_2": "ETMC",
            "city": "CARTHAGE",
            "state": "TX",
            "postal_code": "75633",
            "telephone_number": "903-694-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 COTTAGE ROAD",
            "address_2": "ETMC",
            "city": "CARTHAGE",
            "state": "TX",
            "postal_code": "75633",
            "telephone_number": "903-694-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALVIYA",
        "first_name": "PRAKASH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2011-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "189949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "189949",
            "identifier": "CAREPLUS",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01553277",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carthage, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.