Active NPI
Majdee Islam, M.D.
- Urology Physician
- Saint Peters, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 202103769
- Practice address
- 112 Piper Hill Dr Ste 12
Saint Peters, MO 63376-1690 - Phone
- (636) 996-9202
- NPI assigned
- Mar 30, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | A170568 | CA | |
| Urology Physician | 208800000X | 036158975 | IL | |
| Student in an Organized Health Care Education/Training Program | 390200000X | CO | ||
| Urology Physician | 208800000X | 202103769 | MO | Primary |
Addresses
Primary practice location
112 Piper Hill Dr Ste 12
Saint Peters, MO 63376-1690
Mailing address
12855 N 40 Dr Ste 375
Saint Louis, MO 63141-8657
Phone (314) 567-6071
Other practice location 1
326 Fountains Pkwy
Fairview Heights, IL 62208-2041
Phone (618) 277-3109
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
12855 N 40 Dr
Suite 375
Saint Louis, MO 63141-8657
Phone (314) 567-6071
6812 State Route 162 200
Maryville, IL 62062-8562
Phone (618) 288-0900
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21386 | WI | MD | Family Medicine Physician |
| A170568 | CA | MD | Urology Physician |
| 202103769 | MO | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Urology of St. Louis, Inc. | Urology | Current | Accepting new patients |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Urology of St. Louis, Inc. | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Urology of St. Louis, Inc. | Urology | Past | Accepting new patients |
Locations
2 Saint Anthonys Way
Ste 300
Alton, IL 62002
Phone (618) 462-2226
2 Memorial Dr
Ste 102
Alton, IL 62002
Phone (618) 288-0900
326 Fountains Pkwy
Fairview Heights, IL 62208
Phone (618) 277-3109
2044 Madison Ave
Ste G7
Granite City, IL 62040
Phone (314) 500-2424
6812 State Route 162
Ste 200
Maryville, IL 62062
Phone (618) 288-0900
3 Saint Elizabeth Blvd
Ste 3200
O Fallon, IL 62269
Phone (618) 489-8030
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
12855 N 40 Dr
Ste 375
Saint Louis, MO 63141
12855 N 40 Dr
Ste Ll
Saint Louis, MO 63141
12855 N 40 Dr
Saint Louis, MO 63141
Phone (314) 432-4415
112 Piper Hill Dr
Ste 12
Saint Peters, MO 63376
Phone (314) 806-1770
1965 S Fremont Ave
Ste 370
Springfield, MO 65804
Phone (417) 820-0300
2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905
Interoperability endpoints
- majdeeislam@slus.allscriptsdirect.net
- mislam@yourcarecommunity.org
Organizations & group practices 7
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.
-
dba Neurosurgery of St Louis
- Specialist
- Saint Louis, MO
- NPI 1528017191
IL, Urology
-
- Family Medicine Physician
- Springfield, MO
- NPI 1245277631
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
-
dba Mercy Clinic Family Medicine-Willow Springs
- Rural Health Clinic/Center
- Willow Springs, MO
- NPI 1972771657
-
dba patton pharmacy and v&s variety
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
-
- Urology Physician
- Fairview Heights, IL
- NPI 1528901287
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1487663506
-
- General Acute Care Hospital
- Alton, IL
- NPI 1548278476
-
dba Memorial Hospital
- General Acute Care Hospital
- Belleville, IL
- NPI 1982796181
-
dba HSHS St. Elizabeth's Hospital
- General Acute Care Hospital
- O'Fallon, IL
- NPI 1629057302
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662681600000",
"number": "1447645304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12855 N 40 DR STE 375",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418657",
"telephone_number": "314-567-6071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 PIPER HILL DR STE 12",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633761690",
"telephone_number": "636-996-9202"
}
],
"practiceLocations": [
{
"address_1": "326 Fountains Pkwy",
"address_purpose": "LOCATION",
"city": "Fairview Heights",
"state": "IL",
"postal_code": "622082041",
"country_code": "US",
"telephone_number": "618-277-3109",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ISLAM",
"first_name": "MAJDEE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-03-30",
"last_updated": "2022-09-09",
"certification_date": "2022-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "CA",
"license": "A170568",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "IL",
"license": "036158975",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CO",
"license": null,
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "MO",
"license": "202103769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Peters, MO
- Kimberly Anne Insalaco, OTR/L
- Integrated Lab Consulting LLC (integrated labs llc)
- Integrative Psychiatric Services LLC
- Interlab LLC
- Internal Medicine & Geriatrics Associates, Inc
- J Mandava LLC
- J. Kevin McGraw D.D.S., P.C.
- Jack W. Haney, D.D.S., P.C. (Excellence In Dentistry)
- Kasey Jackson, MA, LPC
- Marley Jackson, NP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; 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.