Individual provider Active NPI

Sunil Malhotra, MD

  • Internal Medicine Physician
  • Southaven, MS
National Provider Identifier
1841369907
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
14796 Issued in MS
Practice address
470 Goodman Road
Southaven, MS 38671-9557
Phone
(662) 536-3330
Fax
(662) 536-3329
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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 14796 MS Primary

Addresses

Primary practice location

470 Goodman Road
Southaven, MS 38671-9557

Mailing address

470 Goodman Rd E
Southaven, MS 38671-9557
Phone (662) 536-3330

Other practice location 1

7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone (662) 772-2980

Other identifiers 1

IdentifierTypeStateIssuer
00117366MedicaidMS

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20050614001146 MS Practitioner - Internal Medicine 2860436425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunil Malhotra 2 clinicians

Practice addresses (Care Compare)

470 Goodman Rd
Southaven, MS 38671-9557

470 Goodman Rd E
Southaven, MS 38671-9557

Hospital & facility affiliations

  • Vitalcaring Group Home health agency, Cleveland, MS, CCN 257016
  • Accentcare Home Health of Greenwood Home health agency, Greenwood, MS, CCN 257131
  • Baptist Home Care and Hospice North Mississippi Home health agency, Batesville, MS, CCN 257114
  • Shepherd Hospice Care, LLC Hospice, New Albany, MS, CCN 251709
  • Baptist Memorial Hospital Desoto Hospital, Southaven, MS, CCN 250141
  • Landmark of Desoto Nursing home, Horn Lake, MS, CCN 255281

Merit-based Incentive Payment System (MIPS)

Final score
21.78 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
72.59

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14796MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sunil Malhotra MD LLC CurrentSince Jan 1, 1990 Accepting new patients
Sunil Malhotra Internal Medicine CurrentSince May 13, 1996 Accepting new patients
Desoto Community Care Center LLC Past Accepting new patients
Baptist Memorial Hospital-Desoto, Inc, Past Accepting new patients

Locations

7601 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-4000

470 Goodman Rd E
Southaven, MS 38671
Phone (662) 536-3330

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Landmark of DesotoHorn Lake, MS, CCN 255281 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Jul 22, 2017
Jul 22, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 6

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1841369907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 GOODMAN RD E",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719557",
            "telephone_number": "662-536-3330",
            "fax_number": "662-536-3329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 GOODMAN ROAD",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719557",
            "telephone_number": "662-536-3330",
            "fax_number": "662-536-3329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7601 Southcrest Pkwy",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386714739",
            "country_code": "US",
            "telephone_number": "662-772-2980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALHOTRA",
        "first_name": "SUNIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "14796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00117366",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.