Individual provider Active NPI

Anju Malieckal, M.D.

  • Gastroenterology Physician
  • Brooklyn, NY
National Provider Identifier
1932409547
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
258628 Issued in NY
Practice address
8714 5TH Ave
Brooklyn, NY 11209-5204
Phone
(718) 630-8600
NPI assigned
Oct 28, 2010
Last updated
Apr 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 258628 NY
Gastroenterology Physician 207RG0100X 258628 NY Primary

Addresses

Primary practice location

8714 5TH Ave
Brooklyn, NY 11209-5204

Mailing address

8714 5TH Ave
Brooklyn, NY 11209-5204

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amalieckal113780@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20140806002518 NY Practitioner - GastroenterologyPractitioner - Internal Medicine 4385861897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

150 55TH St
Brooklyn, NY 11220-2508
Phone (718) 630-7000

8714 5TH Ave
Brooklyn, NY 11209-5204
Phone (718) 630-8600

97 Amity St
Brooklyn, NY 11201-6004
Phone (212) 598-6784

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy172
Upper gastrointestinal (GI) endoscopy for acid reflux118

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University Internal Medicine CurrentSince Sep 1, 2015 Accepting new patients
New York University Internal Medicine CurrentSince Sep 1, 2015 Accepting new patients
NYU Lutheran Medical Center Past Accepting new patients

Locations

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7123

150 55th St
Rm 3618
Brooklyn, NY 11220
Phone (718) 630-7477

6740 4th Ave
Fl 3
Brooklyn, NY 11220
Phone (929) 455-2000

70 Atlantic Ave
Fl 2
Brooklyn, NY 11201
Phone (929) 455-2500

8714 5th Ave
Brooklyn, NY 11209
Phone (718) 630-8600

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: amalieckal113780@nyumc.direct-ci.com

Organizations & group practices 3

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 7

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": "1288224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1932409547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8714 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112095204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8714 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112095204",
            "telephone_number": "718-630-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIECKAL",
        "first_name": "ANJU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-28",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "258628",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "258628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amalieckal113780@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "8714 5th Ave",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112095204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.