NPIMap

Individual provider Active NPI

Satya Venkata Subramanyam Malladi, M.D.

  • Surgery Physician
  • Spokane, WA
National Provider Identifier
1790902088
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD60509476 Issued in WA
Practice address
9922 N Nevada St
Spokane, WA 99218-1126
Phone
(509) 747-6194
Fax
(509) 838-0824
NPI assigned
Apr 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD60509476 WA Primary

Addresses

Primary practice location

9922 N Nevada St
Spokane, WA 99218-1126

Mailing address

PO Box 421
Liberty Lake, WA 99019-0421
Phone (866) 747-2455

Other identifiers 2

IdentifierTypeStateIssuer
0341379OtherWALABOR & INDUSTRIES
2042560MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150520001262 WA Practitioner - General Surgery 6406082015 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9922 N Nevada St
Spokane, WA 99218-1126
Phone (509) 747-6194

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)29
Hernia repair (minimally invasive)1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Surgical Specialists, PS Surgery CurrentSince Apr 1, 2015 Accepting new patients
Columbia Surgical Specialists, PS CurrentSince Apr 1, 2015 Accepting new patients
Providence Health & Services Washington CurrentSince Aug 8, 2022 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients
Providence Health & Services - Washington Past Accepting new patients
Providence Health & Services - Wa Past Accepting new patients

Locations

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

217 W Cataldo Ave
Fl 3
Spokane, WA 99201
Phone (509) 624-2326

217 W Cataldo Ave
Spokane, WA 99201
Phone (509) 624-2326

9922 N Nevada St
Spokane, WA 99218
Phone (509) 624-2326

Interoperability endpoints

  • Direct secure messaging: smalladi507649@wm.providencedirect.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1790902088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "866-747-2455",
            "fax_number": "509-227-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9922 N NEVADA ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181126",
            "telephone_number": "509-747-6194",
            "fax_number": "509-838-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLADI",
        "first_name": "SATYA VENKATA",
        "middle_name": "SUBRAMANYAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD60509476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0341379",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2042560",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.