DR. MALLIK A PIDURU (M.D.) – Surgery Physician, NPI 1265405997

Surgery Physician

DR. MALLIK A PIDURU (M.D.) is a healthcare provider. based in Brooksville, Florida. specializing in Surgery Physician. They hold the professional credentials M.D.. They hold a License No. ME0044053 (FL). The NPI Number for DR. MALLIK A PIDURU (M.D.) is 1265405997

Main info

Male

44 Years Of Experience

Accepts Medicare Assignment

Name

DR. MALLIK A PIDURU (M.D.)

NPI

1265405997

Phone

(352) 799-0046

Address

15215 CORTEZ BLVD

Enumeration Date

13 February 2006

Last Update Date

24 January 2012

Doctor Profile

Medical School Name

OTHER

Secondary Phone

3525967860

Graduation Year

1982 (44 years ago)

PAC ID

6608822176

Group Practice PAC ID

4385821156

Professional Enrollment ID

I20050728000455

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience59

Completeness75

Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for DR. MALLIK A PIDURU (M.D.)

Cortez Boulevard, Brooksville, Hernando County, Florida, United States
BROOKSVILLE, FL 346136072
Phone: (352) 799-0046
Fax: (727) 861-1881
Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 34613)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 4385821156View full group profile

Name	Specialty	State
MRS. YOLANDA CUBERO DIAZ (M.D.)	General Practice	PR
DR. DHAMMIKA EKANAYAKE (M.D.)	Internal Medicine	FL
DR. DAVID HERNDON (DO)	Family Practice	FL
DR. MANJUSRI VENNAMANENI (MD)	Internal Medicine	FL
NATHAN T GLASS (PA-C)	Physician Assistant	PA
DR. ANTHONY JR. ISENALUMHE (MD)	A N E S T H E S I O L O G Y	FL
LUIS ANTONIO JOVEL (MD)	Family Practice	FL
MR. VENKATA RAO EMANDI (M.D.)	-	FL
DR. GRIGOR VARLAKOV (MD)	Family Practice	FL
INNA KULYNA (APRN)	Nurse Practitioner	FL