Individual provider Active NPI

Tanvira M Islam, MD

  • Psychiatry Physician
  • Flushing, NY
National Provider Identifier
1023252137
Registry record updated Sep 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
281495-1 Issued in NY
Practice address
4500 Parsons Blvd
Flushing, NY 11355
Phone
(718) 406-8268
NPI assigned
Apr 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 281495-1 NY Primary

Addresses

Primary practice location

4500 Parsons Blvd
Flushing, NY 11355

Mailing address

11401 Union Turn Pike
Forest Hills, NY 11375
Phone (646) 620-8047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160112000168 NY Practitioner - Psychiatry 7719114925 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maimonides Department of Psychiatry FPPGroup PAC ID 0042115487, 34 clinicians

Practice addresses (Care Compare)

4802 10TH Ave
Brooklyn, NY 11219-2916
Phone (718) 283-8165

Hospital & facility affiliations

  • Maimonides Medical Center Hospital, Brooklyn, NY, CCN 330194

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
281495-1NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jamaica Psychiatric Services, PC CurrentSince Nov 4, 2015 Accepting new patients
Maimonides Department of Psychiatry FPP Psychiatry CurrentSince Dec 26, 2018 Accepting new patients
Maimonides Medical Center Current Accepting new patients
Carmel Psychological Health, PC CurrentSince May 1, 2020 Accepting new patients
Maimonides Faculty Practice Plan CurrentSince Dec 26, 2018 Accepting new patients
Anesthesiology Associates of Boro Park, LLP Past Accepting new patients
MMC OB-GYN Faculty Practice Plan Past Accepting new patients

Locations

2525 Kings Hwy
Brooklyn, NY 11229
Phone (718) 692-5300

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

4802 10th Ave
#C
Brooklyn, NY 11219
Phone (718) 283-8163

920 48th St
Brooklyn, NY 11219
Phone (718) 283-7800

667 Stoneleigh Ave
Ste 202
Carmel, NY 10512
Phone (845) 278-5223

4500 Parsons Blvd
Flushing, NY 11355
Phone (718) 670-5631

8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: tanviraislam@mai.allscriptsdirect.net
  • Direct secure messaging: tanvira.islam.p1@direct.mmc.nextgenshare.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1023252137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11401 UNION TURN PIKE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "646-620-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 PARSONS BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11355",
            "telephone_number": "718-406-8268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "TANVIRA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-21",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "281495-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.