Individual provider Active NPI

Malica Deepti Mantrala, MD

  • Pediatrics Physician
  • Gilbert, AZ
National Provider Identifier
1770938284
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
59057 Issued in AZ
Practice address
6285 S Higley Rd
Gilbert, AZ 85298-4262
Phone
(480) 460-4949
Fax
(480) 460-5858
NPI assigned
May 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

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 59057 AZ Primary

Addresses

Primary practice location

6285 S Higley Rd
Gilbert, AZ 85298-4262

Mailing address

6285 S Higley Rd
Gilbert, AZ 85298-4262
Phone (480) 460-4949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20200313001715 AZ Practitioner - Pediatric Medicine 3678901295 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Medical Group CurrentSince Jan 29, 2020 Accepting new patients
Phoenix Children'S Hospital Pediatrics CurrentSince Jan 29, 2020 Accepting new patients
Desert Shores Pediatrics Pediatrics PastSince Jul 19, 2020 Accepting new patients

Locations

60 S Kyrene Rd
Ste 1
Chandler, AZ 85226
Phone (480) 785-8700

3592 S Atherton Blvd
Ste 101
Gilbert, AZ 85297
Phone (480) 269-0786

2550 E Guadalupe Rd
Ste 115
Gilbert, AZ 85234
Phone (480) 214-2300

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

3200 E Camelback Rd
Ste 250
Phoenix, AZ 85018
Phone (602) 933-1814

6301 S McClintock Dr
Ste 101
Tempe, AZ 85283
Phone (480) 214-2300

Interoperability endpoints

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1770938284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6285 S HIGLEY RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852984262",
            "telephone_number": "480-460-4949",
            "fax_number": "480-460-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6285 S HIGLEY RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852984262",
            "telephone_number": "480-460-4949",
            "fax_number": "480-460-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTRALA",
        "first_name": "MALICA",
        "middle_name": "DEEPTI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-03",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "59057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.