Individual provider Active NPI

Devika Malhotra, MD

  • Pediatrics Physician
  • Glendale, AZ
National Provider Identifier
1780098384
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
62149 Issued in AZ
Practice address
20221 N 67TH Ave Ste E3
Glendale, AZ 85308-0602
Phone
(623) 462-1981
Fax
(623) 400-3348
NPI assigned
Jun 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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 62149 AZ Primary

Addresses

Primary practice location

20221 N 67TH Ave Ste E3
Glendale, AZ 85308-0602

Mailing address

11022 N 28TH Dr Ste 100
Phoenix, AZ 85029-5634
Phone (623) 462-1981

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
I20211015002587 AZ Practitioner - Pediatric Medicine 5890911051 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kidfinity PC Pediatrics CurrentSince Feb 9, 2024 Accepting new patients

Locations

20221 N 67th Ave
Ste E3
Glendale, AZ 85308
Phone (602) 371-4978

20211 N 67th Ave
Ste E3
Glendale, AZ 85308

11022 N 28th Dr
Ste 100
Phoenix, AZ 85029

Interoperability endpoints

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

Organizations & group practices 1

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": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1780098384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11022 N 28TH DR STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850295634",
            "telephone_number": "623-462-1981",
            "fax_number": "623-400-3348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20221 N 67TH AVE STE E3",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853080602",
            "telephone_number": "623-462-1981",
            "fax_number": "623-400-3348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALHOTRA",
        "first_name": "DEVIKA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-12",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "62149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.