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DIVYA MALLAM MD
NPI 1437437613
Internal Medicine - Gastroenterology in New York, NY

Active since July 22, 2011PECOS EnrolledAccepts Medicare Assignment
76.26/100
CMS Quality Rating
80 MAIDEN LN RM 1204, NEW YORK, NY 10038(212) 427-8761(212) 427-8762 Get Directions Write a Review

NPPES record last updated: July 14, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 14, 2026, Mar 19, 2026, Oct 19, 2021 and 2 more (5 updates tracked since 2019).

About Divya Mallam Md NPPES

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

DIVYA MALLAM MD (NPI 1437437613) is an individual gastroenterology provider in New York, New York, licensed in Wisconsin (103660-875) and active in the NPI registry since July 2011. She is enrolled in Medicare PECOS, is affiliated with Aurora Medical Ctr Oshkosh, and maintains a secondary practice location in Oshkosh.

NPPES Registry Identity

NPI1437437613
Entity TypeIndividualFemale
Primary Taxonomy207RG0100X
Provider Legal NameDIVYA MALLAMCredential: MD
Location Address80 MAIDEN LN RM 1204New York, NY 10038-4721
Mailing Address80 Maiden Ln Rm 1204New York, NY 10038-4721 · (212) 427-8761 · Fax (212) 427-8762
Phone(212) 427-8761
Fax(212) 427-8762
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateJuly 22, 2011
Last NPPES UpdateJuly 14, 20265 updates tracked since enumeration
NPPES CertifiedJuly 14, 2026
✔ NPI 1437437613 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
Licenses✔ Licensed in WI · 103660-875✔ Licensed in CA · A123488✔ Licensed in NY · 328761
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
80 MAIDEN LN RM 1204, New York, NY 10038
Open in Google Maps ↗

Secondary Practice Location 1

Location 1855 N Westhaven DrOshkosh, WI 54904-7668 · Phone (920) 303-8700

Other Identifiers 1

Medicaid100415064WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource (Common Ground Healthcare).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Divya Mallam Md 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 ID1254600638
PECOS Enrollment IDI20260519000221
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Divya Mallam reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Manhattan Gastroenterology P.C.
2.3 mi
Gastroenterology
55 W 17TH ST
New York, NY 10011
  • Reassigned Medicare billing, New York enrollment
  • Medicare enrollment name: Manhattan Gastroenterology PC
  • 19 clinicians in this Medicare group
NPI 1922396472 (212) 427-8761
Aurora Medical Group, Inc.
734 mi
Clinic/Center
2414 KOHLER MEMORIAL DR
Sheboygan, WI 53081
  • Reassigned Medicare billing, Wisconsin enrollment
  • 4,609 clinicians in this Medicare group
NPI 1174670244 (920) 457-4461
Pih Health Physicians
2,371 mi
Interventional Cardiology
399 E HIGHLAND AVE STE 424
San Bernardino, CA 92404
  • Reassigned Medicare billing, California enrollment
  • 840 clinicians in this Medicare group
NPI 1821758111 (909) 949-3977

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
27 services22 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
14 services11 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
13 services13 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
12 services12 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
11 services11 patients

Hospital Affiliations CMS Care Compare

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

Aurora Medical Ctr Oshkosh

Acute Care Hospitals · Oshkosh, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520198
Location855 N Westhaven DriveOshkosh, WI 54904 · Winnebago County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10038 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
$150.24 typical visit price
range $65.69 – $198.19
Typical copayment $37.56 (range $16.42 – $49.54)
Most-billed visit code 99204
Established Patient
$114.88 typical visit price
range $21.20 – $160.66
Typical copayment $28.72 (range $5.30 – $40.16)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

76.26/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality62.74
Improvement Activities40
Cost59.29

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Divya Mallam's NPI number?

The NPI number for Divya Mallam is 1437437613. It was assigned to this individual provider in the NPPES registry on July 22, 2011.

Where is Divya Mallam located?

Divya Mallam practices at 80 Maiden Ln Rm 1204, New York, NY 10038. The listed phone number is (212) 427-8761.

What is Divya Mallam's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Divya Mallam enrolled in Medicare?

Yes. Divya Mallam is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Divya Mallam's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Divya Mallam reassigns Medicare benefits to 3 organizations: Manhattan Gastroenterology P.C. (New York, NY), Aurora Medical Group, Inc. (Sheboygan, WI) and Pih Health Physicians (San Bernardino, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Divya Mallam's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Divya Mallam accept?

Health plans from CareSource (Common Ground Healthcare) list Divya Mallam as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Divya Mallam affiliated with any hospitals?

According to CMS data, Divya Mallam is affiliated with Aurora Medical Ctr Oshkosh.

When was this NPI record last updated?

The NPPES record for Divya Mallam was last updated on July 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.