Individual provider Active NPI

Maheen Islam, MD

  • Psychiatry Physician
  • East Chicago, IN
National Provider Identifier
1508443193
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
01096984A Issued in IN
Practice address
4321 Fir St
East Chicago, IN 46312-3049
Phone
(219) 392-7466
Fax
(219) 392-7470
NPI assigned
Mar 28, 2021
Last updated
Aug 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 01096984A IN Primary

Addresses

Primary practice location

4321 Fir St
East Chicago, IN 46312-3049

Mailing address

8558 Broadway
Merrillville, IN 46410-7032
Phone (219) 392-7084

Other practice location 1

4320 Fir St
Unit 4141
East Chicago, IN 46312
Phone (219) 392-7466

Other identifiers 2

IdentifierTypeStateIssuer
1105255318OtherINANTHEM
300115269MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20250620001101 IN Practitioner - Psychiatry 8628478385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Florida State University College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

4321 Fir St
East Chicago, IN 46312-3049
Phone (219) 392-7005

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc CurrentSince Jul 1, 2025 Accepting new patients

Locations

4321 Fir St
East Chicago, IN 46312
Phone (219) 392-1700

1500 S Lake Park Ave
Hobart, IN 46342
Phone (219) 942-0551

8558 Broadway
Merrillville, IN 46410
Phone (219) 392-7084

901 MacArthur Blvd
Munster, IN 46321
Phone (219) 703-1443

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1616889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1508443193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8558 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107032",
            "telephone_number": "219-392-7084",
            "fax_number": "219-703-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 FIR ST",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463123049",
            "telephone_number": "219-392-7466",
            "fax_number": "219-392-7470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4320 Fir St",
            "address_2": "Unit 4141",
            "address_purpose": "LOCATION",
            "city": "East Chicago",
            "state": "IN",
            "postal_code": "46312",
            "country_code": "US",
            "telephone_number": "219-392-7466",
            "fax_number": "219-392-7470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "MAHEEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-28",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01096984A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "1105255318",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300115269",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Chicago, IN

Sources for this page

Verify at the official NPI Registry.