MOHAMMAD K MALIK, M.D.

NPI 1619962438, individual, Ellwood City, PA, Internal Medicine

Evidence tier

documented action, then payment

Listed on the Medicare revocation list since April 30, 2021.
Medicaid still paid claims in 2 later months, $847 in total.

score 93 of 100, rank 403, $847 at stake

Public list actions

Medicare revocation effective April 30, 2021, barred from re-enrolling until April 30, 2031

424.535(a)(9) failure to report and 424.535(a)(12) other program termination (medicaid) and 424.535(a)(3) felonies, Practitioner - Internal Medicine, PA

Paid after the action

Months in which Medicaid paid claims for this provider after a public action that should have triggered a screening check. This is a record of payments, not a determination that they were improper.

list	identity check	action date	window closed	months paid after	first	last	paid after	12 months before
Medicare revocation list 424.535(a)(9) failure to report and 424.535(a)(12) other program termination (medicaid) and 424.535(a)(3) felonies	Exact NPI, name verified	Apr 30, 2021	Apr 30, 2031	2	Jun 2021	Jul 2021	$847	$4K

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	MOHAMMAD K MALIK, M.D.
Type	Individual, sole proprietor
Status	Active
NPI issued	September 19, 2005, last updated August 2, 2013
Practice location	419 SPRING AVE, Ellwood City, PA 16117-2336, 724-758-7524
Specialties	Internal Medicine (207R00000X, primary, license MD037698L PA)

Procedures billed

The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.

Medicaid, largest codes

code	what it is	paid	share	per patient-month	typical	rank among providers
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	$6K	100%	$39	$44 (top 5% from $110)	42nd percentile

In this area

129 providers in PA carry an indicator in the public record, with $49.2M at stake between them. The most common is part of a provider network, on 76 of them, followed by more hours than a day holds on 30. 16 are tier 1: documented action, then payment.

tier	provider	at stake	why
1	BERNARD OGON King Of Prussia, PA, ranked 85	$460K	Listed on the Medicare revocation list since September 25, 2019. Medicaid still paid claims in 15 later months, $460,082 in total.
1	TRI-STATE VISITING HOME PHYSICIANS Bristol, PA, ranked 91	$377K	Listed on the Medicare revocation list since September 25, 2019. Medicaid still paid claims in 14 later months, $377,042 in total.
1	COOL WATERS, LLC Harrisburg, PA, ranked 128	$137K	Listed on a Department of Justice release since October 15, 2024. Medicaid still paid claims in 1 later month, $136,503 in total. and 1 more
1	A PART OF OUR FAMILY HOME CARE AGENCY LLC Bally, PA, ranked 132	$132K	Adjudicated (sentenced) per a state attorney general release dated June 13, 2025. Medicaid paid $131,646 in the last 12 observed months.
1	YITZCHOK KURTZER Scranton, PA, ranked 209	$37K	Listed on the Medicare revocation list and the NY Medicaid exclusion list since September 29, 2021. Medicaid still paid claims in 32 later months, $36,641 in total.
1	MATTHEW DEGIROLAMO Willow Grove, PA, ranked 290	$10K	Listed on the Medicare revocation list since March 1, 2024. Medicaid still paid claims in 3 later months, $9,741 in total.
1	JOSEPH THOMAS Erie, PA, ranked 396	$984	Listed on the NY Medicaid exclusion list since November 14, 2022. Medicaid still paid claims in 1 later month, $984 in total.
1	PLEASANT HILLS APOTHECARY Clairton, PA, ranked 420	$452	Listed on the Medicare revocation list since March 14, 2013. Medicaid still paid claims in 1 later month, $452 in total.

All 129 in PA

Recent enforcement in PA

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJChargedAug 4, 2026

The Fraud Division Announces Charges Against 19 Defendants for Medicaid Home Health Aid Schemes

Nineteen defendants, including owners and employees of home care companies, home health aides, and Medicaid recipients, were charged with submitting claims for home care services that were not provided, including claims for hours when purported aides were incarcerated, hospitalized, working other jobs, or traveling overseas.

DOJIndictedJun 23, 2026

Two Doctors, Physician’s Assistant Charged With Unlawfully Distributing Controlled Substances Via Voicemail “Refill Line”

From January 2020 through March 2025 the defendants allegedly operated a voicemail refill line that allowed patients to receive refills of Schedule II controlled substance prescriptions, namely oxycodone and amphetamine, without interacting with a licensed prescriber, and submitted prescriptions in another medical professional's name to deceive pharmacies.

DOJChargedJun 23, 2026

Scranton Woman Charged With Conspiracy To Commit Bank Fraud With Funds Derived From Federal Health Care Programs

Beaubrun is alleged to have stolen and appropriated checks intended by Entity #1 for various payees, including funds derived from Medicare and Medicaid, and endorsed them to herself, causing a loss of over $300,000.

DOJCivil settlementJun 10, 2026

Ahold Delhaize USA Inc. to Pay $40M for Allegedly Reporting Inflated Drug Prices on Claims to Federal Healthcare Programs

Ahold Delhaize's in-store retail pharmacies operated prescription savings programs offering discounted prices but failed to report those discounted prices as their "usual and customary" prices on claims to Medicare Part D, Medicaid and TRICARE, causing those programs to pay inflated amounts.

DOJCivil settlementJun 10, 2026

Ahold Delhaize USA Inc. to Pay $40M for Allegedly Reporting Inflated Drug Prices on Claims to Federal Healthcare Programs

Ahold Delhaize supermarket pharmacies operated prescription savings programs offering discounted prices but failed to report those discounted prices as their "usual and customary" prices on claims to Medicare Part D, Medicaid, and TRICARE, causing those programs to pay inflated amounts.

Referral packet

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