Kaniz Fatema Islam, FNP, PMHNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AZ5476 Issued in AZ

Practice address

5209 W Siesta Way
Laveen, AZ 85339-7179

Phone

(602) 352-9898

Fax

(949) 247-5542

NPI assigned

Apr 2, 2014

Last updated

May 20, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kaniz.islam@direct.digidms.com

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.

• Ceb Capital LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1750754982
  Medicare reassignment NPD
• Aneeshi Health LLC

  • Family Nurse Practitioner
  • Laveen, AZ
  • NPI 1073234639
  NPD Authorized official
• Ceb Capital LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1073986212
  NPD

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

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1366860843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5209 W SIESTA WAY",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853397179",
            "telephone_number": "602-550-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5209 W SIESTA WAY",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853397179",
            "telephone_number": "602-352-9898",
            "fax_number": "949-247-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "KANIZ",
        "middle_name": "FATEMA",
        "credential": "FNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-02",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AZ5476",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AZ5476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "902324",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Innovista Tech Solutions LLC
• Innovista Tech Solutions LLC
• Integrative Medical Group
• Into Action Recovery Inc
• Into Action Recovery, Inc
• Ivy Home Care LLC (Ivy Home Care)
• Jackson Medical Solutions, Inc. (JMS)
• Jalamar Compassionate Caregivers LLC
• Harris Jatoi, DDS
• JDL-Ctspa

• Family Nurse Practitioner in Laveen, AZ
• Providers in Laveen, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.