Individual provider Active NPI

Pramod Malik, M.D.

  • Gastroenterology Physician
  • Suffolk, VA
National Provider Identifier
1902882954
Registry record updated May 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
0101231641 Issued in VA
Practice address
3910 Bridge Rd Ste 101
Suffolk, VA 23435-1107
Phone
(757) 942-2566
Fax
(855) 313-1070
NPI assigned
Dec 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 0101231641 VA Primary

Addresses

Primary practice location

3910 Bridge Rd Ste 101
Suffolk, VA 23435-1107

Mailing address

3910 Bridge Rd Ste 101
Suffolk, VA 23435-1107
Phone (757) 942-2566

Other practice location 1

4017 River Park Dr
Suffolk, VA 23435-3356
Phone (757) 725-1984

Other identifiers 2

IdentifierTypeStateIssuer
010103061MedicaidVA
159847OtherVAANTEM OF VA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20050113000092 VA Practitioner - Gastroenterology 8325096837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virginia Gastroenterology Institute PCGroup PAC ID 1951604677, 9 clinicians

Practice addresses (Care Compare)

2790 Godwin Blvd
Suite 205
Suffolk, VA 23434-8154
Phone (757) 942-2566

Hospital & facility affiliations

  • Sentara Obici Hospital Hospital, Suffolk, VA, CCN 490044
  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007

Merit-based Incentive Payment System (MIPS)

Final score
92.95 of 100Reported as individual
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
76.5

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy319
Upper gastrointestinal (GI) endoscopy for acid reflux250

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Gastroenterology Institute PC Gastroenterology CurrentSince Jan 1, 2016 Accepting new patients
Virginia Gastroenterology Institute PC CurrentSince Jun 28, 2020 Accepting new patients

Locations

3910 Bridge Rd
Ste 101
Suffolk, VA 23435
Phone (757) 942-2566

2790 Godwin Blvd
Ste 205
Suffolk, VA 23434
Phone (757) 934-7753

Interoperability endpoints

  • Direct secure messaging: pramod.malik.1@12739.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/12739/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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 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": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1902882954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 BRIDGE RD STE 101",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234351107",
            "telephone_number": "757-942-2566",
            "fax_number": "855-313-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 BRIDGE RD STE 101",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234351107",
            "telephone_number": "757-942-2566",
            "fax_number": "855-313-1070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4017 River Park Dr",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234353356",
            "country_code": "US",
            "telephone_number": "757-725-1984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALIK",
        "first_name": "PRAMOD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101231641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010103061",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTEM  OF VA",
            "identifier": "159847",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.