NPIMap

Individual provider Active NPI

Sudhakar V Mallela, M.D.

  • Infectious Disease Physician
  • Riverside, CA
National Provider Identifier
1851498729
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
C131483 Issued in CA
Practice address
6885 Brockton Ave
Riverside, CA 92506
Phone
(951) 468-1306
Fax
(951) 784-8934
NPI assigned
Sep 20, 2006
Last updated
Mar 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9640 NV
Internal Medicine Physician 207R00000X C131483 CA
Infectious Disease Physician 207RI0200X 9640 NV
Infectious Disease Physician 207RI0200X C131483 CA Primary

Addresses

Primary practice location

6885 Brockton Ave
Riverside, CA 92506

Mailing address

6885 Brockton Ave
Riverside, CA 92506-3811
Phone (951) 462-1306

Other identifiers 1

IdentifierTypeStateIssuer
002018743MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150115001124 CA Practitioner - Infectious DiseasePractitioner - Internal Medicine 7517949662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6885 Brockton Ave
Riverside, CA 92506-3811
Phone (951) 462-1306

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.53 of 100Reported as group
Quality
50
Improvement activities
40
Cost
81.77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C131483CAMDInternal Medicine Physician
9640NVMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sudhakar Venkata Mallela MD Inc Infectious Disease CurrentSince Jul 15, 2016 Accepting new patients
Prime Community Care, Inc. Past Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients
Dignity Health Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Uhs Corona Inc Past Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients
Doctors Hospital of Riverside LLC Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Infectious Diseases Consultants Infectious Disease Past Accepting new patients

Locations

6885 Brockton Ave
Riverside, CA 92506
Phone (951) 462-1306

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

1001 Avenida Pico
Ste C494
San Clemente, CA 92673

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 12

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 1

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1851498729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6885 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063811",
            "telephone_number": "951-462-1306",
            "fax_number": "951-784-8934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6885 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92506",
            "telephone_number": "951-468-1306",
            "fax_number": "951-784-8934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLELA",
        "first_name": "SUDHAKAR",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "9640",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C131483",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NV",
            "license": "9640",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "C131483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002018743",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.