Sami Afrin Islam

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

104409 Issued in CA

Practice address

2934 N Fresno St
Fresno, CA 93703-1123

Phone

(559) 549-6697

NPI assigned

Aug 10, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: telemed2u.samiislam@160918.advancedmd-direct.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.

• Central Star Behavioral Health, Inc.

  • Community/Behavioral Health Agency
  • Fresno, CA
  • NPI 1255218905
  NPD (past)

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636156800000",
    "number": "1194336537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 W SHAW AVE STE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113229",
            "telephone_number": "559-558-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2934 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937031123",
            "telephone_number": "559-549-6697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "SAMI",
        "middle_name": "AFRIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2021-11-06",
        "certification_date": "2021-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "104409",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Isak, RN
• Lee Anne Ishmael, BCBA
• Mytzy Isidoro
• Tania Isidra-Damaso
• Mohammed Shafayetul Islam
• Ayman M Ismail, DDS
• Dannette Amiel Isom-Norman
• Janice Elaine Isom
• Savannah Lou Ellen Marie Isom, ACSW
• Fortuna Israel, MD

• Mental Health Counselor in Fresno, CA
• Providers in Fresno, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2021; 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.