NPIMap

Organization Active NPI

Malik Eye Institute, L.L.C.

  • Ophthalmology Physician
  • Rockford, IL
National Provider Identifier
1902906803
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MALIK EYE INSTITUTE, L.L.C.
Practice address
3865 N. Mulford Rd.
Rockford, IL 61114-5603
Phone
(815) 399-2190
Fax
(815) 399-5543
NPI assigned
Sep 22, 2006
Last updated
Mar 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Authorized official

Name
Dr. Masud I Malik, M.D.NPI 1679580807
Title
Phyisician/Owner
Phone
(815) 399-2190

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X IL Primary

Addresses

Primary practice location

3865 N. Mulford Rd.
Rockford, IL 61114-5603

Mailing address

3865 N Mulford Rd
Rockford, IL 61114-5603
Phone (815) 399-2190

Other names 1

  • Masud Malik, M.D. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061121000501 IL Part B Supplier - Clinic/Group Practice 2668470980 Receives reassigned benefits from 4 practitioners
Practice locations: Rockford, IL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Malik Eye Institute LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • Direct secure messaging: apalmer-hall@esor.intellechartdirect.net
  • Direct secure messaging: dturok@esor.intellechartdirect.net
  • Direct secure messaging: mmalik@esor.intellechartdirect.net
  • Direct secure messaging: mperacha@esor.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1902906803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3865 N MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611145603",
            "telephone_number": "815-399-2190",
            "fax_number": "815-399-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3865 N. MULFORD RD.",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611145603",
            "telephone_number": "815-399-2190",
            "fax_number": "815-399-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALIK EYE INSTITUTE, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "MALIK",
        "authorized_official_first_name": "MASUD",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PHYISICIAN/OWNER",
        "authorized_official_telephone_number": "815-399-2190",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Masud Malik, M.D.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.