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Tulika Agarwal Malhotra

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

PECOS Enrollment

This provider is enrolled in PECOS as TULIKA MALHOTRA.

Based on the most recent information from CMS, provider Tulika Agarwal Malhotra is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1518319672
Provider Type
Individual
Full Name
Malhotra, Tulika Agarwal
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
7/12/2016
Last Updated
12/27/2022

Contact Information

Practice Location

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

(503) 494-7551

(503) 494-4997

Mailing Location

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

(503) 494-7551

(503) 494-4997

Provider Taxonomies

Code	Description	License
Code 363AM0700X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA187621 Oregon

Provider Identifiers

ID	Description	Issuer
ID 2098843	Description Medicaid	Issuer Unlisted Washington
ID 500742405	Description Medicaid	Issuer Unlisted Oregon

Tulika Agarwal Malhotra

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Holmes, Lauren Rebecca

Schell, Allison Lynn

Thoms, Trisha A

Mostafavifar, Mina

Kjornes, Briana

Hill, Anya

Saleen, Avantika

Lechich, Kirstie Macmillen

Barclift, Hannah

Rodgers, Dawn