Individual provider Active NPI

MD Aticul Islam, MD

  • Infectious Disease Physician
  • Middletown, NY
National Provider Identifier
1184822660
Registry record updated Nov 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
244927 Issued in NY
Practice address
155 Crystal Run Rd
Middletown, NY 10941-4028
Phone
(845) 703-6999
Fax
(845) 703-6297
NPI assigned
Jul 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 244927 NY Primary

Addresses

Primary practice location

155 Crystal Run Rd
Middletown, NY 10941-4028

Mailing address

155 Crystal Run Rd
Middletown, NY 10941-4028
Phone (845) 703-6999

Other identifiers 1

IdentifierTypeStateIssuer
02974821MedicaidNY

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
I20080626000310 NY Practitioner - Infectious DiseasePractitioner - Internal Medicine 9537231154 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TJH Medical Services PCGroup PAC ID 8527960533, 215 clinicians
Jamaica HospitalGroup PAC ID 2264324334, 252 clinicians

Practice addresses (Care Compare)

11940 Metropolitan Ave
Kew Gardens, NY 11415-2600
Phone (718) 849-0839

13303 Jamaica Ave
Richmond Hill, NY 11418-2618
Phone (718) 291-3276

8900 Van Wyck Expy
Jamaica, NY 11418-2832
Phone (718) 206-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.19 of 100Reported as group
Quality
82.16
Promoting interoperability
79
Improvement activities
40
Cost
75.98

Merit-based Incentive Payment System (MIPS)

Final score
85.41 of 100Reported as group
Quality
64.77
Promoting interoperability
79
Improvement activities
40
Cost
70.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Jamaica Hospital CurrentSince Aug 24, 2011 Accepting new patients
TJH Medical Services, P.C. CurrentSince Aug 24, 2011 Accepting new patients
Jamaica Hospital CurrentSince Aug 24, 2011 Accepting new patients
Jamaica Hospital Past Accepting new patients
Inpatient Consultants of Tennessee, P.C. Past Accepting new patients
Jamaica Hospital Past Accepting new patients

Locations

11940 Metropolitan Ave
Kew Gardens, NY 11415
Phone (718) 849-0839

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

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

Networks

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

Interoperability endpoints

  • Direct secure messaging: aislam7510@direct.medisys.org

Organizations & group practices 6

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": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258502400000",
    "number": "1184822660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414028",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414028",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "MD",
        "middle_name": "ATICUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-06",
        "last_updated": "2009-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NY",
            "license": "244927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02974821",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.