Vinod Govindaraj Maller, M.D.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

54534 Issued in TN

Practice address

848 Adams Ave
Memphis, TN 38103-2816

Phone

(901) 287-7337

Fax

(901) 287-6042

NPI assigned

Aug 4, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Interventional Radiology

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ut Lebonheur Pediatric Specialists, Inc.Group PAC ID 7719173939, 162 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vmaller21466@stjude.direct-ci.com
• Direct secure messaging: vmaller34772@mlh.direct-ci.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.

• Ut Lebonheur Pediatric Specialists, Inc.

  • Pediatrics Physician
  • Memphis, TN
  • NPI 1093024101
  Medicare reassignment Care Compare group
• St Jude Children'S Research Hospital, Inc.

  • Pediatrics Physician
  • Memphis, TN
  • NPI 1306335088
  Medicare reassignment NPD

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

{
    "created_epoch": "1312416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507075200000",
    "number": "1972882207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 POPLAR AVE BLDG 2",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381054607",
            "telephone_number": "901-287-5674",
            "fax_number": "901-287-6804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 ADAMS AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032816",
            "telephone_number": "901-287-7337",
            "fax_number": "901-287-6042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLER",
        "first_name": "VINOD",
        "middle_name": "GOVINDARAJ",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-04",
        "last_updated": "2017-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TN",
            "license": "54534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marc David Malkoff, M.D.
• Barbara Mallady, CRNA
• Saradhi Mallampati
• Corinthia Mallard, SLP
• Vijetha Vinod Maller, M.D
• Jordyn Mallo, MS, RD
• Bailey Mallon, LSGC
• April Nicole Mallory
• Camille Hayes Mallory, NP
• Edith Mallory

• Vascular & Interventional Radiology Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Vascular & Interventional Radiology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; 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.