Individual provider Active NPI

Nafisa Islam, M.D.

  • Family Medicine Physician
  • Brookville, OH
National Provider Identifier
1336356740
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
094840 Issued in OH
Practice address
187 Bruns Dr
Brookville, OH 45309-1112
Phone
(937) 838-4928
NPI assigned
May 16, 2007
Last updated
Mar 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 094840 OH Primary

Addresses

Primary practice location

187 Bruns Dr
Brookville, OH 45309-1112

Mailing address

187 Bruns Dr
Brookville, OH 45309-1112
Phone (937) 838-4928

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20100702000475 OH Practitioner - Family PracticePractitioner - General Practice 8527199736

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
78.18 of 100Reported as group
Quality
64.28
Promoting interoperability
84
Improvement activities
40
Cost
76.33

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
094840OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Urgent Care Inc. Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1336356740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 BRUNS DR",
            "city": "BROOKVILLE",
            "state": "OH",
            "postal_code": "453091112",
            "telephone_number": "937-838-4928",
            "fax_number": "937-838-4928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 BRUNS DR",
            "city": "BROOKVILLE",
            "state": "OH",
            "postal_code": "453091112",
            "telephone_number": "937-838-4928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "NAFISA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "094840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookville, OH

Sources for this page

Verify at the official NPI Registry.