Krishna Mallik, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

37346 Issued in AZ

Practice address

4110 N Scottsdale Rd Ste 215
Scottsdale, AZ 85251-3635

Phone

(855) 804-8800

Fax

(480) 907-2994

NPI assigned

Oct 3, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2014 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• University of Toledo Physicians LLC

  • Internal Medicine Physician
  • Toledo, OH
  • NPI 1942296033

  Orthopaedic Surgery

  NPD (past)

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542499200000",
    "number": "1922095272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7181 E CAMELBACK RD",
            "address_2": "SUITE #303",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852511279",
            "telephone_number": "855-804-8800",
            "fax_number": "480-907-2994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 N SCOTTSDALE RD STE 215",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852513635",
            "telephone_number": "855-804-8800",
            "fax_number": "480-907-2994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLIK",
        "first_name": "KRISHNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-03",
        "last_updated": "2018-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "37346",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "AZ",
            "license": "37346",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Z152366",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madonna C Mallari, MD
• Randy V. Mallari, PMHNP-BC/C, FNP-BC/C
• Renee Mallari
• Robin E. Mallaro, CRNA
• Abigail Malle, PA-C
• Mallin & Seidel Orthopaedic Oncology PLLC
• Gary Craig Mallis, M.D.
• James B Mallory, DMD
• Trena Marie Mallory, CRNA
• Kathleen Malmberg

• Orthopaedic Surgery Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Orthopaedic Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2018; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.