Shakib Wasiful Islam, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

35.141765 Issued in OH

Practice address

3188 Bellevue Ave
Cincinnati, OH 45219-2369

Phone

(513) 584-7355

Fax

(513) 584-0431

NPI assigned

Apr 8, 2019

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

Medicare fee-for-service enrollment

Enrolled in OH, TX2 enrollments

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 2

Specialty

Diagnostic Radiology

Education

Northeastern Ohio University College of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kelsey-Seybold Medical Group, PLLCGroup PAC ID 9739093527, 941 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

82 of 100Reported as group

Quality

65.97

Promoting interoperability

100

Improvement activities

40

Cost

74.01

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sislam203086@direct.kelsey-seybold.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.

• Kelsey-Seybold Medical Group, PLLC

  dba Kelsey Seybold Clinic

  • Multi-Specialty Clinic/Center
  • Houston, TX
  • NPI 1013915255

  Diagnostic Radiology

  Medicare reassignment Care Compare group NPD
• University of Cincinnati Physicians Company, LLC

  • Family Medicine Physician
  • Cincinnati, OH
  • NPI 1801840434
  Medicare reassignment NPD
• University of Cincinnati Medical Center, LLC

  dba University Hospital APN Services

  • Nurse Practitioner
  • Cincinnati, OH
  • NPI 1255352068
  NPD
• University Surgical-Dental Associates, LLC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Cincinnati, OH
  • NPI 1649241787
  NPD (past)

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723334400000",
    "number": "1568925402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3188 BELLEVUE AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192369",
            "telephone_number": "513-584-7355",
            "fax_number": "513-584-0431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Arch St Ste 1B",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443041436",
            "country_code": "US",
            "telephone_number": "330-375-3315",
            "fax_number": "330-375-7779",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1010 S Ponds Dr",
            "address_purpose": "LOCATION",
            "city": "Webster",
            "state": "TX",
            "postal_code": "775981409",
            "country_code": "US",
            "telephone_number": "713-442-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "SHAKIB",
        "middle_name": "WASIFUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-08",
        "last_updated": "2024-08-11",
        "certification_date": "2024-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "V1793",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35.141765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shonda Isham I
• Aireal Ishola
• Jamie K Isidore
• Andrew Shafik Islam, MD, MS
• Elizabeth Ann Islam, NP-C
• Nabeel Ismail, MD
• Cierra Renee Isome
• Deanna Denise Isome
• Dion Lavelle Isome
• Dior C Isome

• Diagnostic Radiology Physician in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Diagnostic Radiology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2024; 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.