Lenkala R Mallaiah, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

ME0037029 Issued in FL

Practice address

311 N Mangoustine Ave
Sanford, FL 32771-1098

Phone

(407) 321-4570

Fax

(407) 321-7690

NPI assigned

Jul 20, 2005

Last updated

Mar 1, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

GastroenterologyAlso: Internal Medicine

Education

Other, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FECGBA/Endpoint/FECGBA

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.

• Mid-Florida Gastroenterology Group P a

  • Specialist
  • Sanford, FL
  • NPI 1841474103
  Medicare reassignment NPD Authorized official
• Reddymed LLC

  • Specialist
  • Leesburg, FL
  • NPI 1821393836
  NPD (past)

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1891794954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 N MANGOUSTINE AVE",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327711098",
            "telephone_number": "407-321-4570",
            "fax_number": "407-321-7690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N MANGOUSTINE AVE",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327711098",
            "telephone_number": "407-321-4570",
            "fax_number": "407-321-7690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLAIAH",
        "first_name": "LENKALA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME0037029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065414100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS/BS",
            "identifier": "59292",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosa Angela Malagon, LCSW
• Mikayla Elise Malcolm, MD
• Anthony John Maldonado, PHARM.D.
• Jenny Ann Maldonado, RBT
• Ruchi Malhotra, LCSW
• Vincent Joseph Mamone, D.O.
• Marianne Mancone, CRPS-F, TCM
• Patrick John Manfrede, PHARMD
• Bhupinder S Mangat, M.D.
• Ashleigh Mann, NP-C

• Gastroenterology Physician in Sanford, FL
• Providers in Sanford, FL by specialty
• Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.