NPIMap

Individual provider Active NPI

Mohammad Islam, MBBS, MPH, PHD

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1184007643
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.132515 Issued in OH
Practice address
1545 Atlantic Ave
Brooklyn, NY 11213-1122
Phone
(718) 613-4000
NPI assigned
Jul 2, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.132515 OH Primary

Addresses

Primary practice location

1545 Atlantic Ave
Brooklyn, NY 11213-1122

Mailing address

556 Thomas S Boyland St
Apt D1
Brooklyn, NY 11212-5058
Phone (812) 202-6569

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20180718003647 OH Practitioner - Internal Medicine 0648527820 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Youngstown Specialty Care LLCGroup PAC ID 3476950296, 463 clinicians

Practice addresses (Care Compare)

1 Akron General Ave
Akron, OH 44307-2432
Phone (330) 344-6000

8401 Market St
Boardman, OH 44512-6725
Phone (330) 729-2929

Hospital & facility affiliations

  • Akron General Medical Center Hospital, Akron, OH, CCN 360027
  • MH St Joseph Warren Hospital Hospital, Warren, OH, CCN 360161
  • Medina Hospital Hospital, Medina, OH, CCN 360091
  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest General Medical Group Inc Internal Medicine Current Accepting new patients
Mercy Health Physicians Youngstown, LLC Internal Medicine Current Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Southwest General Medical Group Inc CurrentSince Oct 7, 2020 Accepting new patients
Hospitalist Medicine Physicians of Richland County, LTD Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Southwest General Medical Group, Inc CurrentSince Oct 7, 2020 Accepting new patients
Hospitalist Medicine Physicians of Ohio, Professional Corporation Internal Medicine CurrentSince Jul 1, 2018 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown LLC CurrentSince Jun 6, 2020 Accepting new patients
Community Hospitalist, LLC Internal Medicine CurrentSince Jun 1, 2020 Accepting new patients
Mercy Health Youngstown LLC Past Accepting new patients

Locations

1 Akron General Ave
Akron, OH 44307
Phone (330) 344-5760

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

3700 Kolbe Rd
Lorain, OH 44053
Phone (440) 331-9520

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

7255 Old Oak Blvd
Ste C202
Middleburg Heights, OH 44130
Phone (440) 816-5390

1111 Hayes Ave
Sandusky, OH 44870
Phone (419) 557-7455

667 Eastland Ave SE
Warren, OH 44484
Phone (330) 841-2378

8401 Market St
Youngstown, OH 44512
Phone (330) 729-2929

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

Organizations & group practices 11

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 5

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": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554336000000",
    "number": "1184007643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "556 THOMAS S BOYLAND ST",
            "address_2": "APT D1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112125058",
            "telephone_number": "812-202-6569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 ATLANTIC AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112131122",
            "telephone_number": "718-613-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "MOHAMMAD",
        "credential": "MBBS, MPH, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-02",
        "last_updated": "2019-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.132515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.