Malica Deepti Mantrala, in Phoenix, AZ

Malica Deepti Mantrala, is a medicare enrolled "Pediatrics" physician in Phoenix, Arizona. Her current practice location is 2601 E Roosevelt St, Phoenix, Arizona. You can reach out to her office (for appointments etc.) via phone at (222) 222-2222.

Malica Deepti Mantrala is licensed to practice in Arizona (license number 59057) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1770938284.

Contact Information

	Malica Deepti Mantrala,
	2601 E Roosevelt St, Phoenix, AZ 85008-4973
	(222) 222-2222
	Not Available

Map and Direction

Physician's Profile

Full Name	Malica Deepti Mantrala
Gender	Female
Speciality	Pediatrics
Location	2601 E Roosevelt St, Phoenix, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1770938284
Provider Enumeration Date: 05/03/2016
Last Update Date: 02/27/2020

Medicare PECOS Information:

PECOS PAC ID: 3678901295
Enrollment ID: I20200313001715

Medical Identifiers

Medical identifiers for Malica Deepti Mantrala such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1770938284	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	59057 (Arizona)	Primary
390200000X	Student In An Organized Health Care Education/training Program	(* (Not Available))	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Malica Deepti Mantrala allows following entities to bill medicare on her behalf.

Entity Name	Phoenix Children's Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1922112044 PECOS PAC ID: 0446278584 Enrollment ID: O20051107000704

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Malica Deepti Mantrala is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Malica Deepti Mantrala, 3200 E Camelback Rd, Ste 250, Phoenix, AZ 85018-2327 Ph: (602) 933-1814	Malica Deepti Mantrala, 2601 E Roosevelt St, Phoenix, AZ 85008-4973 Ph: (222) 222-2222

Reviews and Comments

Pediatrics Doctors in Phoenix, AZ

Dr. Amit Rajaram, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 1919 E Thomas Rd, Phoenix, AZ 85016 Phone: 602-933-0198
Dr. Patricia Ranjinee Halpe, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3141 N 3rd Ave, Phoenix, AZ 85013 Phone: 602-914-1520 Fax: 602-914-1521
Dr. Angela Monique Valdez-huizar, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 3333 E Van Buren St, Phoenix, AZ 85008 Phone: 602-933-0945 Fax: 602-933-4263
Benjmamin Thomas Carlson, PTA Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5314 N 7th St, Phoenix, AZ 85014 Phone: 602-277-5006
Julianna Diddle, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1919 E Thomas Rd, Phoenix, AZ 85016 Phone: 602-933-1000
Alexandra Palacios, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1919 E Thomas Rd, Phoenix, AZ 85016 Phone: 602-933-0945
Dr. Salil V. Pradhan, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2525 E Roosevelt St, Phoenix, AZ 85008 Phone: 602-344-5404 Fax: 602-344-5859

Malica Deepti Mantrala, - Medicare Pediatrics in Phoenix, AZ