MD Moinul Islam, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA09504 Issued in TX

Practice address

6030 W. University
Odessa, TX 79764

Phone

(432) 640-6600

Fax

(432) 640-4790

NPI assigned

Dec 15, 2014

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

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mislam397188@direct.stlukeshealth.org

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.

• Ector County Hospital District

  • Urgent Care Clinic/Center
  • Odessa, TX
  • NPI 1366680555
  Medicare reassignment NPD (past)
• Angelina Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Lufkin, TX
  • NPI 1518397298
  Medicare reassignment
• Concord Medical Group of Texas PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1750790762
  Medicare reassignment
• Concord Medical Group PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1083630610
  Medicare reassignment
• Elite Hospital Partners, PLLC

  • Emergency Medicine Physician
  • Allen, TX
  • NPI 1609625995
  Medicare reassignment
• Emergency Medicine Services of TX, PLLC

  • Emergency Medicine Physician
  • San Antonio, TX
  • NPI 1245938729
  Medicare reassignment
• Ess of Nacogdoches LLC

  • Emergency Medicine Physician
  • Nacogdoches, TX
  • NPI 1780139956
  Medicare reassignment
• Integrative Emergency Services Physician Group-Houston PLLC

  • Emergency Medicine Physician
  • Pasadena, TX
  • NPI 1801458708
  Medicare reassignment
• Maverick Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Eagle Pass, TX
  • NPI 1306806781
  Medicare reassignment
• Memorial Hermann Hospital Based Physician Group

  • Emergency Medicine Physician
  • Houston, TX
  • NPI 1295363497
  Medicare reassignment
• St Joseph Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Houston, TX
  • NPI 1326324047
  Medicare reassignment
• Texas Em-I Medical Services PA

  • Emergency Medicine Physician
  • Angleton, TX
  • NPI 1437334414
  Medicare reassignment

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

{
    "created_epoch": "1418601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1184022758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2129",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797602129",
            "telephone_number": "432-640-6600",
            "fax_number": "432-640-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6030 W. UNIVERSITY",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "79764",
            "telephone_number": "432-640-6600",
            "fax_number": "432-640-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "MD MOINUL",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-15",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• International Locum Tenens
• Interventional Partners PLLC
• Ali Irani
• Eduardo Alejandro Iregui, MD
• Osnay Isasi Gazmuri, FNP-C
• Sajjudal Islam Sr., M.D.
• Teresa Ann Isom
• J a Mayans MD PA
• J&B Senior and Disabled Services
• Ali Jabur, MD

• Physician Assistant in Odessa, TX
• Providers in Odessa, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.