Mohammad Raqibul Islam, M.D.

Primary specialty

Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X

License

54033 Issued in AZ

Practice address

13400 E Shea Blvd
Scottsdale, AZ 85259

Phone

(480) 301-8000

NPI assigned

Jun 25, 2013

Sex

Male

Sole proprietor

No

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

Enrolled in AZ

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

Obstetrics/Gynecology

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Banner Physician Specialists Arizona LLCGroup PAC ID 6204002272, 371 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Banner Physician Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1821368218
  Medicare reassignment Care Compare group
• Banner - University Physician Specialists LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1437529245
  Medicare reassignment NPD
• Banner - University Physician Specialists LLC

  • Multi-Specialty Clinic/Center
  • Maricopa, AZ
  • NPI 1063887727
  NPD
• Banner - University Physician Specialists LLC

  • Durable Medical Equipment & Medical Supplies
  • Phoenix, AZ
  • NPI 1164255865
  NPD
• Banner Physician Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1316228802
  NPD
• Banner Physician Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Page, AZ
  • NPI 1366799355
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Banner - University Medical Center Phoenix

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1841224870
  Care Compare affiliation

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552608000000",
    "number": "1306286158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595452",
            "telephone_number": "480-301-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85259",
            "telephone_number": "480-301-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 E Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "48912",
            "country_code": "US",
            "telephone_number": "517-364-2570",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1215 E Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "48912",
            "country_code": "US",
            "telephone_number": "517-364-2570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "MOHAMMAD",
        "middle_name": "RAQIBUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-25",
        "last_updated": "2019-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301103735",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "AZ",
            "license": "54033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Irvine
• Jillian Irwin, LMFT
• Alan Jay Isaacson, R.PH.
• Alyssa Kara Ishimoto, MD
• Irma Iskandar, D.M.D., M.S.
• Island Dream Devlopment LLC
• Angel Patricio Islas Canales, PT
• Nazifa Ismail, NP
• Sagal Ismail
• Zahra Ispahany, CNM

• Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; 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.