Faiza Kamal Mallick, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

311732 Issued in NY

Practice address

755 Park Ave Ste 145
Huntington, NY 11743-3975

Phone

(631) 261-4445

NPI assigned

Mar 26, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Family Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

North Shore Hematology Oncology Associates PCGroup PAC ID 1456243641, 474 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Catholic Home Care Home health agency, Farmingdale, NY, CCN 337147
• Centerwell Home Health Home health agency, Hauppauge, NY, CCN 337232
• Constellation Home Care Home health agency, Syosset, NY, CCN 337447

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles (1 of 5)

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: faiza.mallick.p1@direct.saintjosephs.nextgenshare.com

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.

• North Shore Hematology Oncology Associates PC

  • Specialist
  • Port Jefferson Station, NY
  • NPI 1396794574

  Multi-Specialty, NY

  Medicare reassignment Care Compare group NPD

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

• QC-Medi New York, Inc.

  • Home Health Agency
  • Hauppauge, NY
  • NPI 1376575977
  Care Compare affiliation Name & address match
• Constellation Home Care LLC

  • Home Health Agency
  • Syosset, NY
  • NPI 1841629698
  Care Compare affiliation
• Nursing Sisters Home Care, Inc.

  • Home Health Agency
  • Farmingdale, NY
  • NPI 1780670711
  Care Compare affiliation

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1780189597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 PARK AVE STE 145",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117437513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 PARK AVE STE 145",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433975",
            "telephone_number": "631-261-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLICK",
        "first_name": "FAIZA",
        "middle_name": "KAMAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "311732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Main Street Internal Medicine, PLLC
• Robert James Maiorino, DDS
• Sohail Majid, DPM
• Denise A. Maletta, L.AC./LMT
• Radhika Malhotra, MD
• Samantha S Maloney, FNP-BC
• Rama Bindu Manchikalapudi, M.D.
• Joseph Mancini, M.D.
• Ashley Nicole Mangi, PA-C
• Gianna Marie Mangieri, DO

• All providers in Huntington, NY
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.