NPIMap

Individual provider Active NPI

M Fatin Ishtiaq, M.D.

  • Internal Medicine Physician
  • Manchester, NH
National Provider Identifier
1215674858
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34561 Issued in NH
Practice address
100 McGregor St
Manchester, NH 03102-3770
Phone
(332) 260-8749
NPI assigned
May 16, 2022
Reactivated
Jan 23, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 34561 NH Primary

Addresses

Primary practice location

100 McGregor St
Manchester, NH 03102-3770

Mailing address

506 6TH Street
Brooklyn, NY 11215
Phone (718) 780-5130

Other practice location 1

506 6th Street
Brooklyn, NY 11215
Phone (718) 780-5130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20250625001261 NH Practitioner - Internal Medicine 9537671508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Services of NH, LLCGroup PAC ID 8527423706, 88 clinicians

Practice addresses (Care Compare)

100 McGregor St
Manchester, NH 03102-3730
Phone (603) 668-3545

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34561NHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine Services of NH, LLC CurrentSince Aug 1, 2025 Accepting new patients
Manchester Health Services, LLC Past Accepting new patients

Locations

1 Parkland Dr
Derry, NH 03038
Phone (603) 421-2220

100 McGregor St
Manchester, NH 03102
Phone (603) 663-6931

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: rrb9008@direct.nyp.org

Organizations & group practices 2

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 6

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": "1652659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1215674858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 6TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11215",
            "telephone_number": "718-780-5130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MCGREGOR ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031023770",
            "telephone_number": "332-260-8749"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "506 6th Street",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11215",
            "country_code": "US",
            "telephone_number": "718-780-5130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISHTIAQ",
        "first_name": "M FATIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-16",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "deactivation_date": "2023-01-13",
        "reactivation_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "34561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.