Individual provider Active NPI

Bishal Malla, FNP

  • Family Nurse Practitioner
  • Columbia, MD
National Provider Identifier
1801485768
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R237810 Issued in MD
Practice address
10840 Little Patuxent Pkwy Ste 105
Columbia, MD 21044-3254
Phone
(410) 730-2028
NPI assigned
Jan 14, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R237810 MD Primary

Addresses

Primary practice location

10840 Little Patuxent Pkwy Ste 105
Columbia, MD 21044-3254

Mailing address

5205 Chairmans CT
Ste 201a
Frederick, MD 21703-2918
Phone (240) 629-3939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210302000546 MD Practitioner - Nurse Practitioner 6406262377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amber Hill Physical Therapy IncGroup PAC ID 8527963917, 336 clinicians
Advanced Pain Management, LLCGroup PAC ID 9335406016, 2 clinicians

Practice addresses (Care Compare)

187 Thomas Johnson Dr
Suite 6
Frederick, MD 21702-4503

5205 Chairmans CT
Suite 201a
Frederick, MD 21703-2918
Phone (240) 629-3939

Merit-based Incentive Payment System (MIPS)

Final score
93.92 of 100Reported as group
Quality
87.63
Promoting interoperability
100
Improvement activities
40
Cost
81.8

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Pain Management,LLC CurrentSince Feb 15, 2022 Accepting new patients
Advanced Pain Management, LLC CurrentSince Feb 15, 2022 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

5205 Chairmans Ct
Ste 201A
Frederick, MD 21703
Phone (240) 629-9399

5205 Chairmans Ct
#201A
Frederick, MD 21703

5205 Chairmans Ct
Ste 201B
Frederick, MD 21703

11637 Terrace Dr
Ste 101
Waldorf, MD 20602
Phone (240) 629-3955

Interoperability endpoints

  • Direct secure messaging: bishal.malla.1@15863.direct.athenahealth.com

Organizations & group practices 4

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": "1610582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1801485768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5205 CHAIRMANS CT",
            "address_2": "STE 201A",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217032918",
            "telephone_number": "240-629-3939",
            "fax_number": "240-629-3940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10840 LITTLE PATUXENT PKWY STE 105",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443254",
            "telephone_number": "410-730-2028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLA",
        "first_name": "BISHAL",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-14",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R237810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.