Individual provider Active NPI

Tahiya Islam, PA-C

  • Physician Assistant
  • Fort Smith, AR
National Provider Identifier
1215659081
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1001 Towson Ave
Fort Smith, AR 72901-4921
Phone
(423) 426-3918
NPI assigned
Sep 16, 2022
Last updated
Jul 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085010409 IL
Physician Assistant 363A00000X AR Primary

Addresses

Primary practice location

1001 Towson Ave
Fort Smith, AR 72901-4921

Mailing address

13500 Chenal Pkwy Apt 3023
Little Rock, AR 72211-5206
Phone (870) 540-6370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230329002081 AR Practitioner - Physician Assistant 9931573151 Reassigns benefits to 5 organizations
I20250710002108 IL Practitioner - Physician Assistant 9931573151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cook Physician Services, P.C.Group PAC ID 4082053434, 59 clinicians

Practice addresses (Care Compare)

1555 Barrington Rd
Hoffman Estates, IL 60169-1019
Phone (847) 843-2000

355 Ridge Ave
Evanston, IL 60202-3328
Phone (847) 316-4000

800 Biesterfield Rd
Elk Grove Village, IL 60007-3397
Phone (847) 437-5500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085010409ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Services CurrentSince Apr 1, 2023 Accepting new patients
PMC Services LLC PastSince Jun 29, 2025 Accepting new patients

Locations

1001 Towson Ave
Fort Smith, AR 72901
Phone (479) 441-3980

1120 Lexington Ave
Fort Smith, AR 72901
Phone (479) 709-7245

1500 Dodson Ave
Ste 285B
Fort Smith, AR 72901
Phone (479) 709-7025

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

211 Crawford Memorial Dr
Van Buren, AR 72956
Phone (479) 471-4300

Interoperability endpoints

  • Direct secure messaging: tislam683790@direct.baptist-healthar.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1215659081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13500 CHENAL PKWY APT 3023",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722115206",
            "telephone_number": "870-540-6370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 TOWSON AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729014921",
            "telephone_number": "423-426-3918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "TAHIYA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-16",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085010409",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.