Raquibul Islam, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD062423L Issued in PA

Practice address

125 E 9TH St
Chester, PA 19013-6019

Phone

(671) 872-6131

Fax

(610) 872-5128

NPI assigned

May 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Internal Medicine

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chespenn Health ServicesGroup PAC ID 5991695389, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Main Line Health Home Care & Hospice - Home Health Home health agency, Radnor, PA, CCN 397012
• Riddle Memorial Hospital Hospital, Media, PA, CCN 390222

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: raquibul.islam.1@28169.direct.athenahealth.com

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.

• Chespenn Health Services

  • Federally Qualified Health Center (FQHC)
  • Chester, PA
  • NPI 1750329603
  Medicare reassignment Care Compare group NPD
• Chespenn Health Services

  • Federally Qualified Health Center (FQHC)
  • Upper Darby, PA
  • NPI 1225272263
  NPD
• Chespenn Health Services

  • Federally Qualified Health Center (FQHC)
  • Coatesville, PA
  • NPI 1396799417
  NPD (past)

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

• Riddle Memorial Hospital

  • General Acute Care Hospital
  • Media, PA
  • NPI 1407856099
  Care Compare affiliation

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1174577035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 W 9TH ST",
            "address_2": "2 NORTH",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190132040",
            "telephone_number": "610-485-3800",
            "fax_number": "610-485-4221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E 9TH ST",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190136019",
            "telephone_number": "671-872-6131",
            "fax_number": "610-872-5128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "RAQUIBUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD062423L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016718790005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Conrad Irons Jr.
• Connie Irvin II
• Renee Irvin
• Lewis M Irving, DMD
• Terrisha Irving, BA
• Shereia Ison
• Lailah Israeli, MPH
• Ayanna Jackson, MSW, LCSW
• Caralotta D Jackson
• Deborah Jackson

• Internal Medicine Physician in Chester, PA
• Providers in Chester, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.