Organization Active NPI

Malapati Inc

Doing business as Dr Premesh Malapati

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1790161289
Registry record updated Sep 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036114832 Issued in IL
Legal business name
MALAPATI INC
Doing business as
Dr Premesh Malapati
Practice address
5600 W Addison St Lowr 1LL
Chicago, IL 60634-4444
Phone
(630) 748-9373
NPI assigned
Aug 6, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2021

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

Authorized official

Name
Dr. Premesh Malapati, M.D.NPI 1730136763
Title
Owner
Phone
(630) 748-9373

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 036114832 IL Primary

Addresses

Primary practice location

5600 W Addison St Lowr 1LL
Chicago, IL 60634-4444

Mailing address

824 Marengo Ave
Forest Park, IL 60130-2033
Phone (630) 748-9373

Other identifiers 1

IdentifierTypeStateIssuer
036114832MedicaidIL

Other names 1

  • Dr Premesh Malapati Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150916001020 IL Part B Supplier - Clinic/Group Practice 9537476031 Receives reassigned benefits from 2 practitioners
Practice locations: Chicago, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2276241Malapati Inc5600 W Addison St Ll003, Chicago, IL 60634Certificate of waiverFeb 5, 2027

National Provider Directory

National Provider Directory

Locations

5600 W Addison St
Lowr 3LL
Chicago, IL 60634
Phone (708) 722-2572

5600 W Addison St
Lowr 1LL
Chicago, IL 60634
Phone (773) 202-9622

1111 Superior St
Ste 410
Melrose Park, IL 60160
Phone (312) 345-0555

Interoperability endpoints

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631404800000",
    "number": "1790161289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 MARENGO AVE",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302033",
            "telephone_number": "630-748-9373",
            "fax_number": "888-668-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 W ADDISON ST LOWR 1LL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344444",
            "telephone_number": "630-748-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALAPATI INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-06",
        "last_updated": "2021-09-12",
        "certification_date": "2021-09-12",
        "status": "A",
        "authorized_official_last_name": "MALAPATI",
        "authorized_official_first_name": "PREMESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-748-9373",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036114832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036114832",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr Premesh Malapati",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dr Premesh Malapati",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.