NIBU JACOB MALAICKAL, REEGT, RPSGT,RNCST — NPI 1578033254 (Licensed & Credentialed Specialist/Technologist, Other, EEG in COPPELL, TX)

CMS-1500 Box 24J / 33a • NPI

1578033254

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

246ZE0500X

Licensed & Credentialed Specialist/Technologist, Other, EEG

Box 32 Service Location & ZIP+4

304 S COPPELL RD, COPPELL, TX, 75019-2417

✓ 9-Digit EDI 837 ZIP+4 (75019-2417)

Practice Phone & Referral Fax

(214) 686-9393

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1578033254 (NIBU JACOB MALAICKAL, REEGT, RPSGT,RNCST) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1578033254` (NPI-1 Individual Practitioner)
Provider / Legal Name	NIBU JACOB MALAICKAL, REEGT, RPSGT,RNCST
Plain-English Specialty	Licensed & Credentialed Specialist/Technologist, Other, EEG NUCC Code: `246ZE0500X` (Specialist/Technologist, Other, EEG)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	304 S COPPELL RD, COPPELL, TX, 75019-2417
Practice Telephone / Fax	Tel: (214) 686-9393
Administrative Mailing Address	304 S COPPELL RD, COPPELL, TX, 75019-2417
Enumeration & Last Sync	Enumerated: 2018-11-26 \| CMS Record Updated: 2018-11-26

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

304 S COPPELL RD, COPPELL, TX, 75019-2417

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Plain-English Taxonomy & CMS Crosswalk (246ZE0500X)

What Does Taxonomy Code 246ZE0500X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 246ZE0500X translates to:
"Licensed & Credentialed Specialist/Technologist, Other, EEG"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Specialist/Technologist, Other, EEG for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (NIBU JACOB MALAICKAL, REEGT, RPSGT,RNCST)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`273100000X` — Epilepsy Unit Plain English: Licensed & Credentialed Hospital Units — Epilepsy Unit	State: N/A \| License: `138` \| Primary: Secondary
`246ZE0500X` — Specialist/Technologist, Other, EEG Plain English: Licensed & Credentialed Specialist/Technologist, Other, EEG	State: N/A \| License: `4499` \| Primary: Yes (Primary)
`246ZE0600X` — Specialist/Technologist, Other, Electroneurodiagnostic Plain English: Licensed & Credentialed Specialist/Technologist, Other, Electroneurodiagnostic	State: N/A \| License: `878` \| Primary: Secondary
`261QS1200X` — Clinic/Center, Sleep Disorder Diagnostic Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `16863` \| Primary: Secondary

Medical Billing, RCM & Hospital Credentialing Teams:

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NIBU JACOB MALAICKAL, REEGT, RPSGT,RNCST (NPI #1578033254)