NPIMap

Individual provider Active NPI

Vikram R Malladi, MD

  • Gastroenterology Physician
  • Greenbrae, CA
National Provider Identifier
1902814015
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A102626 Issued in CA
Practice address
1350 S Eliseo Dr
Greenbrae, CA 94904-2011
Phone
(415) 925-6900
NPI assigned
Aug 4, 2006
Last updated
May 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A102626 CA Primary
Gastroenterology Physician 207RG0100X L7623 TX

Addresses

Primary practice location

1350 S Eliseo Dr
Greenbrae, CA 94904-2011

Mailing address

200 Tamal Plaza
Suite 200
Corte Madera, CA 94925
Phone (415) 925-6900

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
I20080919000443 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 5294833026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of Texas Medical School at San Antonio, 2000
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Regents Univ of California UCSFGroup PAC ID 6305160300, 276 clinicians

Practice addresses (Care Compare)

505 Parnassus Ave
San Francisco, CA 94143-2204
Phone (415) 476-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.03 of 100Reported as subgroup
Quality
80.86
Promoting interoperability
76
Improvement activities
40
Cost
75.91

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy163
Upper gastrointestinal (GI) endoscopy for acid reflux180

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents Univ of California UCSF CurrentSince May 4, 2021 Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Marin General Hospital Past Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

200 Tamal Plz
Ste 200
Corte Madera, CA 94925
Phone (415) 925-6900

1100 S Eliseo Dr
Ste 3
Greenbrae, CA 94904
Phone (415) 464-0606

1350 S Eliseo Dr
Greenbrae, CA 94904
Phone (415) 925-3690

7120 Redwood Blvd
Novato, CA 94945
Phone (415) 925-6900

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

Interoperability endpoints

  • Direct secure messaging: vmalladi@maringastro.directbygreenway.com
  • Direct secure messaging: vmalladi105778@direct-ucsfmedicalcenter.org
  • Direct secure messaging: vmalladi210101@hisp.ehr.sutterhealth.org

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

Hospital & facility affiliations 3

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1902814015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TAMAL PLAZA",
            "address_2": "SUITE 200",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "94925",
            "telephone_number": "415-925-6900",
            "fax_number": "415-925-6919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S ELISEO DR",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042011",
            "telephone_number": "415-925-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLADI",
        "first_name": "VIKRAM",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A102626",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "L7623",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbrae, CA

Sources for this page

Verify at the official NPI Registry.