NPIMap

Individual provider Active NPI

Mahmuda Islam, MD

  • Family Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1144457193
Registry record updated Apr 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P2683 Issued in TX
Practice address
10864 Texas Health TRL
Fort Worth, TX 76244-4897
Phone
(682) 212-3160
Fax
(682) 212-9301
NPI assigned
Jun 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X P2683 TX Primary

Addresses

Primary practice location

10864 Texas Health TRL
Fort Worth, TX 76244-4897

Mailing address

10864 Texas Health TRL
Fort Worth, TX 76244-4897
Phone (682) 212-3160

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120831000499 TX Practitioner - Family Practice 9335396035 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

10864 Texas Health TRL
Fort Worth, TX 76244-4897
Phone (682) 212-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P2683TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group Current Accepting new patients
Texas Health Physicians Group Family Medicine CurrentSince Apr 1, 2013 Accepting new patients
Texas Health Physicians Group CurrentSince Apr 1, 2013 Accepting new patients
Texas Health Virtual Care CurrentSince Feb 1, 2024 Accepting new patients
Texas Health Virtual Care CurrentSince Feb 1, 2024 Accepting new patients
Texas Health Harris Methodist Hospital Alliance Past Accepting new patients
Rusk Physician Services PA Past Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

8200 Walnut Hill Ln
Fl 9
Dallas, TX 75231
Phone (214) 345-8001

10864 Texas Health Trl
Fort Worth, TX 76244
Phone (682) 212-2000

341 Wheatfield Dr
Ste 100
Sunnyvale, TX 75182
Phone (972) 329-1996

Interoperability endpoints

  • Direct secure messaging: mislam257564@direct.texashealth.org
  • FHIR API: https://epproxy.texashealth.org/FHIR/api/FHIR/DSTU2/

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 3

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": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396915200000",
    "number": "1144457193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10864 TEXAS HEALTH TRL",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762444897",
            "telephone_number": "682-212-3160",
            "fax_number": "682-212-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10864 TEXAS HEALTH TRL",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762444897",
            "telephone_number": "682-212-3160",
            "fax_number": "682-212-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "MAHMUDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-17",
        "last_updated": "2014-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P2683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.