AYESHA MALLICK IMAM M.D.
NPI 1306280094
Internal Medicine in Springfield, OH

Q: What is Ayesha Mallick Imam's NPI number?

The NPI number for Ayesha Mallick Imam is 1306280094. It was assigned to this individual provider in the NPPES registry on April 24, 2013.

Q: What is Ayesha Mallick Imam's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since April 24, 2013PECOS EnrolledAccepts Medicare Assignment

100 MEDICAL CENTER DR, SPRINGFIELD, OH 45504(937) 523-4147 Get Directions Write a Review

NPPES record last updated: November 2, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Ayesha Mallick Imam M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AYESHA MALLICK IMAM M.D. (NPI 1306280094) is an individual internal medicine provider in Springfield, Ohio, licensed in Ohio (35.144361) and active in the NPI registry since April 2013. She is enrolled in Medicare PECOS, is affiliated with Springfield Regional Medical Center, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1306280094

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameAYESHA MALLICK IMAMCredential: M.D.

Location Address100 MEDICAL CENTER DRSpringfield, OH 45504-2687

Mailing Address150 Bergen Street,, Suite E-401Newark,, NJ 07101-1709

Phone(937) 523-4147

Sole ProprietorNo

Medical School CMSOtherGraduated 2009

Enumeration DateApril 24, 2013

Last NPPES UpdateNovember 2, 2022

NPPES CertifiedNovember 2, 2022

✔ NPI 1306280094 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in OH · 35.144361

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

100 MEDICAL CENTER DR, Springfield, OH 45504

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ayesha Mallick Imam M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4284014424

PECOS Enrollment IDI20220706003160

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

175 services81 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

43 services25 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Springfield Regional Medical Center

Acute Care Hospitals · Springfield, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360086

Location100 Medical Center DriveSpringfield, OH 45504 · Clark County

Emergency services Birthing friendly

Soin Medical Center

Acute Care Hospitals · Beaver Creek, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360360

Location3535 Pentagon Park BlvdBeaver Creek, OH 45431 · Greene County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45504 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$126.12 typical visit price

range $54.34 – $166.65

Typical copayment $31.53 (range $13.58 – $41.66)

Most-billed visit code 99204

Established Patient

$96.44 typical visit price

range $17.10 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANDREW EUGENE JOHNSON

Registered Nurse