DR. MALICA DEEPTI MANTRALA MD
NPI 1770938284
Pediatrics in Gilbert, AZ

Q: What is Malica Mantrala's NPI number?

The NPI number for Malica Mantrala is 1770938284. It was assigned to this individual provider in the NPPES registry on May 3, 2016.

Q: What is Malica Mantrala's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Malica Mantrala was last updated on May 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since May 03, 2016PECOS Enrolled

6285 S HIGLEY RD, GILBERT, AZ 85298(480) 460-4949(480) 460-5858 Get Directions Write a Review

NPPES record last updated: May 18, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 18, 2026, Feb 27, 2020, Jan 25, 2017 (3 updates tracked since 2017).

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About Dr. Malica Deepti Mantrala Md NPPES

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

DR. MALICA DEEPTI MANTRALA MD (NPI 1770938284) is an individual pediatrics provider in Gilbert, Arizona, licensed in Arizona (59057) and active in the NPI registry since May 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1770938284

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameDR. MALICA DEEPTI MANTRALACredential: MD

Location Address6285 S HIGLEY RDGilbert, AZ 85298-4262

Mailing Address6285 S Higley RdGilbert, AZ 85298-4262 · (480) 460-4949 · Fax (480) 460-5858

Phone(480) 460-4949

Fax(480) 460-5858

Sole ProprietorNo

Enumeration DateMay 3, 2016

Last NPPES UpdateMay 18, 20263 updates tracked since enumeration

NPPES CertifiedMay 18, 2026

✔ NPI 1770938284 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in AZ · 59057

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

6285 S HIGLEY RD, Gilbert, AZ 85298

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Malica Deepti Mantrala Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Malica Mantrala reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Phoenix Children's Medical Group

11 mi

Multi-Specialty

5131 E SOUTHERN AVE
Mesa, AZ 85206

Reassigned Medicare billing, Arizona enrollment
Medicare enrollment name: Phoenix Children's Hospital
1,416 clinicians in this Medicare group

NPI 1487814240 (602) 933-0002

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85298 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

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

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.

SARAH CATHERINE LANCE PA-C

Physician Assistant (Medical)