A.S.M. Manzurul Islam, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

P5382 Issued in TX

Practice address

1400 S Coulter St
Amarillo, TX 79106-1786

Phone

(806) 414-9100

Fax

(806) 354-5717

NPI assigned

Apr 27, 2010

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TX

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, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ipc Healthcare Services of Texas PLLCGroup PAC ID 3971824939, 184 clinicians

Capital Area Primary Care, PLLCGroup PAC ID 9537237482, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St David'S Medical Center Hospital, Austin, TX, CCN 450431
• Round Rock Medical Center Hospital, Round Rock, TX, CCN 450718

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3648/brand/1/csg/1/fhir/r4
• Direct secure messaging: 50961-islam-asm@direct.leadingreach.com
• Direct secure messaging: asmislam@ttuhsc.allscriptsdirect.net
• Direct secure messaging: 21892-shaw-james@direct.leadingreach.com
• Direct secure messaging: asm.islam@hca8.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.

• Capital Area Primary Care, PLLC

  • Family Medicine Physician
  • Austin, TX
  • NPI 1023287976
  Medicare reassignment Care Compare group NPD
• Ipc Healthcare Services of Texas, PLLC

  • Hospitalist Physician
  • San Antonio, TX
  • NPI 1023403011

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Lonestar Pat Associates PA

  • Hospitalist Physician
  • Round Rock, TX
  • NPI 1811594203

  Internal Medicine

  Medicare reassignment NPD
• Texas Tech University Health Sciences Center Amarillo

  • Internal Medicine Physician
  • Amarillo, TX
  • NPI 1871525840
  Medicare reassignment NPD
• Vibra Physicians LLC

  • Hospitalist Physician
  • Johnstown, CO
  • NPI 1659705424

  TX

  Medicare reassignment NPD
• Texas Tech University Health Sciences Center

  • Pharmacy
  • Lubbock, TX
  • NPI 1609810977
  NPD
• Northwest Texas Healthcare System Inc

  • General Acute Care Hospital
  • Amarillo, TX
  • NPI 1467442418
  NPD (past)

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

• St Davids Healthcare Partnership LP LLP

  • General Acute Care Hospital
  • Round Rock, TX
  • NPI 1649223645
  Care Compare affiliation
• St. Davids Healthcare Partnership, L.P., LLP

  • General Acute Care Hospital
  • Austin, TX
  • NPI 1720033947
  Care Compare affiliation

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

{
    "created_epoch": "1272326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462492800000",
    "number": "1477870707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061708",
            "telephone_number": "806-414-9100",
            "fax_number": "806-354-5717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S COULTER ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061786",
            "telephone_number": "806-414-9100",
            "fax_number": "806-354-5717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "A.S.M.",
        "middle_name": "MANZURUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-27",
        "last_updated": "2016-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "550845",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P5382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200486640 A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "319239501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23022728",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "319239502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kalea Irwin, OTR, MOT
• Michelle Isham
• Moeed Ishrat, LMSW
• Amany Iskander, PHARMD
• Alexander Vladimirovich Iskrenko, M.D., PH.D.
• Thayer Ismaael, MD
• Anna Isom, LPC
• Kim E Israel, MD
• Susmitha Issac
• Jana Ivey, LPC

• Internal Medicine Physician in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.