NPIMap

Individual provider Active NPI

Chetan Malhotra, M.D.

  • Internal Medicine Physician
  • Massapequa, NY
National Provider Identifier
1821028184
Registry record updated Jun 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
220640-1 Issued in NY
Practice address
575 Broadway
Massapequa, NY 11758-5019
Phone
(516) 541-1900
Fax
(516) 612-8834
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 220640-1 NY Primary

Addresses

Primary practice location

575 Broadway
Massapequa, NY 11758-5019

Mailing address

575 Broadway
Massapequa, NY 11758-5019
Phone (516) 541-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040326000207 NY Practitioner - Internal Medicine 5496647331 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chetan Malhotra MD PCGroup PAC ID 7214102607, 2 clinicians

Practice addresses (Care Compare)

575 Broadway
Massapequa, NY 11758-5019
Phone (516) 541-1384

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
220640-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chetan Malhotra, MD P.C. Internal Medicine CurrentSince Aug 7, 2011 Accepting new patients
Excel at Woodbury for Rehabilitation and Nursing LLC Past Accepting new patients
South Shore Magnetic Resonance Imaging Associates PC PastSince Aug 13, 2016 Accepting new patients
Samaritan Medical Services, P.C. Internal Medicine Past Accepting new patients
RS Neuro Medical, P.C. PastSince May 1, 2007 Accepting new patients

Locations

575 Broadway
Massapequa, NY 11758
Phone (516) 541-1384

221 Jericho Tpke
Syosset, NY 11791
Phone (516) 496-6400

Networks

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402185600000",
    "number": "1821028184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 BROADWAY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585019",
            "telephone_number": "516-541-1900",
            "fax_number": "516-612-8834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 BROADWAY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585019",
            "telephone_number": "516-541-1900",
            "fax_number": "516-612-8834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALHOTRA",
        "first_name": "CHETAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2014-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "220640-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

Verify at the official NPI Registry.