Faryal J Mallick, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

ME140149 Issued in FL

Practice address

14003 N Dale Mabry Hwy Ste C
Tampa, FL 33618-2459

Phone

(813) 461-7797

NPI assigned

Apr 5, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL, VA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fmallick425905@direct.shands.ufl.edu
• Direct secure messaging: fmallick267731@direct.rivhs.com

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.

• North Port BH, LLC

  • Psychiatric Hospital
  • North Port, FL
  • NPI 1063258598

  FL

  Medicare reassignment Care Compare group NPD
• Riverside Physician Services Inc

  • Gastroenterology Physician
  • Newport News, VA
  • NPI 1194929026

  VA

  Medicare reassignment Care Compare group NPD
• Hni Medical Services of Florida, LLC

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1679048284

  FL, Psychiatry

  Medicare reassignment NPD
• FMP Family Psychiatry

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tampa, FL
  • NPI 1699614990
  NPD Authorized official
• Riverside Physician Services Inc

  • Ophthalmology Physician
  • Newport News, VA
  • NPI 1083630651
  Care Compare group
• Riverside Physician Services Inc

  • Ophthalmology Physician
  • Newport News, VA
  • NPI 1245253152
  Care Compare group
• Riverside Physician Services Inc

  • Gastroenterology Physician
  • Williamsburg, VA
  • NPI 1083867311
  NPD
• Riverside Physician Services, Inc.

  • Family Medicine Physician
  • Newport News, VA
  • NPI 1710020623
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Riverside Hospital Inc

  • General Acute Care Hospital
  • Newport News, VA
  • NPI 1366547747

  Hospital

  Care Compare affiliation

Specialty

Psychiatry

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Riverside Physician Services Inc 793 clinicians

North Port BH LLC 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052

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

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1962865097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10006 CROSS CREEK BLVD STE 124",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472595",
            "telephone_number": "813-461-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14003 N DALE MABRY HWY STE C",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182459",
            "telephone_number": "813-461-7797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 Pleasant Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Owensboro",
            "state": "KY",
            "postal_code": "423039811",
            "country_code": "US",
            "telephone_number": "270-417-3772",
            "fax_number": "270-417-3709",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 E Chestnut St",
            "address_2": "STE 600",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402025700",
            "country_code": "US",
            "telephone_number": "502-588-4865",
            "fax_number": "502-588-4427",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "439 SW Michigan St",
            "address_purpose": "LOCATION",
            "city": "Lake City",
            "state": "FL",
            "postal_code": "320250440",
            "country_code": "US",
            "telephone_number": "386-487-0800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLICK",
        "first_name": "FARYAL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-05",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "TP944",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "51944",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME140149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100572460",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tori Ann Maliska, MSW, RCSWI
• Sreya Malladi
• Gertie Mallard-Teal
• Heather Mallard
• Dana Renee' Mallen, RRT
• Mallikarjuna Nandyala MD PA
• Alexis Mallon, PA-C
• George Edward Mallory, DO
• Laura Michelle Mallory
• Melissa Anne Mallory, M.D.

• All providers in Tampa, FL
• Child & Adolescent Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.