MD Mahbubul Islam, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

243430 Issued in NY

Practice address

8786 188TH St
Hollis, NY 11423-1131

Phone

(718) 480-6882

Fax

(718) 454-5353

NPI assigned

Mar 17, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Internal Medicine

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sun River Health Inc.Group PAC ID 6608783568, 246 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: mahbubul.islam@hrh.eclinicaldirectplus.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.

• Sun River Health Inc

  • Federally Qualified Health Center (FQHC)
  • Amenia, NY
  • NPI 1568526838
  Medicare reassignment Care Compare group NPD
• Hollis Medical PC

  • Family Medicine Physician
  • Hollis, NY
  • NPI 1356760052
  NPD (past) Authorized official
• Sun River Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Peekskill, NY
  • NPI 1619969458
  NPD

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

{
    "created_epoch": "1174089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477699200000",
    "number": "1285758276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18444 HENLEY RD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114322422",
            "telephone_number": "718-297-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8786 188TH ST",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114231131",
            "telephone_number": "718-480-6882",
            "fax_number": "718-454-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "MD",
        "middle_name": "MAHBUBUL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-17",
        "last_updated": "2016-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "243430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02866613",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Imran Medical Care
• Interventional Pain Medicine PC
• Isak Pharmacy Inc.
• Victoria Isakov, FNP
• Arkadiy Iskhakov
• Rafia Islam
• Sirajul Islam, MD
• Melanie Izrailova
• Joan Laurie Jacobs, D.C.,C.D.N.
• Grace Rosalee James

• Family Medicine Physician in Hollis, NY
• Providers in Hollis, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2016; 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.