Individual provider Active NPI

Taj A Malik, DPM

  • Podiatrist
  • Cleveland Heights, OH
National Provider Identifier
1972669752
Registry record updated Mar 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36002541M Issued in OH
Practice address
5 Severance Circle
Suite 701
Cleveland Heights, OH 44118-1590
Phone
(216) 397-0999
Fax
(216) 397-0983
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 36002541M OH Primary

Addresses

Primary practice location

5 Severance Circle
Suite 701
Cleveland Heights, OH 44118-1590

Mailing address

PO Box 1864
Cleveland Heights, OH 44106-0064
Phone (216) 397-0999

Other identifiers 1

IdentifierTypeStateIssuer
0718512MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130304000306 OH Practitioner - Podiatry 3072768787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5 Severance Cir
Suite 701
Cleveland Heights, OH 44118-1590
Phone (216) 397-0999

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue14
Removal of skin lesions1-10
Removal of nail tissue66

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36002541MOHMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Taj a. Malik DPM PC Inc Podiatrist CurrentSince Jul 19, 1993 Accepting new patients

Locations

5 Severance Cir
Ste 701
Cleveland Heights, OH 44118
Phone (216) 397-0999

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363046400000",
    "number": "1972669752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1864",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441060064",
            "telephone_number": "216-397-0999",
            "fax_number": "216-397-0983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SEVERANCE CIRCLE",
            "address_2": "SUITE 701",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441181590",
            "telephone_number": "216-397-0999",
            "fax_number": "216-397-0983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIK",
        "first_name": "TAJ",
        "middle_name": "A",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2013-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36002541M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0718512",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland Heights, OH

Sources for this page

Verify at the official NPI Registry.