Tajul Islam, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35.129571 Issued in OH

Practice address

5264 Lee Rd
Maple Heights, OH 44137-1232

Phone

(305) 628-6117

NPI assigned

May 15, 2013

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

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

HospitalistAlso: Internal Medicine

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Health Physicians Youngstown Specialty Care LLC 463 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• MH St Elizabeth Youngstown Hospital Hospital, Youngstown, OH, CCN 360064
• HMHP St Elizabeth Boardman Health Center Hospital, Boardman, OH, CCN 360276

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tislam54572@direct-guthrie.org
• Direct secure messaging: tislam200568@direct.metrohealth.org

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.

• Mercy Health Physicians Youngstown Specialty Care LLC

  • Surgery Physician
  • Youngstown, OH
  • NPI 1649892225

  Hospitalist, OH

  Medicare reassignment Care Compare group NPD
• Hospitalist Medicine Physicians of Ohio, Professional Corporation

  • Internal Medicine Physician
  • Columbus, OH
  • NPI 1043572290

  Internal Medicine, OH

  Medicare reassignment NPD
• Mercy Health Physicians Youngstown, LLC

  • Family Medicine Physician
  • Youngstown, OH
  • NPI 1154636066

  Internal Medicine, OH

  Medicare reassignment NPD
• University Hospitals Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Cleveland, OH
  • NPI 1669499414

  OH

  Medicare reassignment NPD
• Dedicated Ohio Holding, LLC

  • Non-Pharmacy Dispensing Site
  • Cincinnati, OH
  • NPI 1164055711
  NPD
• Mercy Health Physicians Youngstown LLC

  • Durable Medical Equipment & Medical Supplies
  • Boardman, OH
  • NPI 1750920245
  NPD
• Mercy Health Physicians Youngstown Specialty Care LLC

  • Diagnostic Radiology Physician
  • Warren, OH
  • NPI 1255009601
  NPD
• Mercy Health Physicians Youngstown Specialty Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Boardman, OH
  • NPI 1386316107
  NPD
• The Metrohealth System

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1700828852
  NPD
• Dedicated Ohio Holding, LLC

  • Non-Pharmacy Dispensing Site
  • Cincinnati, OH
  • NPI 1215566658
  NPD (past)
• Dedicated Ohio Holding, LLC

  • Non-Pharmacy Dispensing Site
  • Cincinnati, OH
  • NPI 1407475643
  NPD (past)
• Mercy Health Youngstown LLC

  • General Acute Care Hospital
  • Youngstown, OH
  • NPI 1548296106
  NPD (past)

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

• Mercy Health Youngstown LLC

  • General Acute Care Hospital
  • Youngstown, OH
  • NPI 1548296106

  Hospital

  Care Compare affiliation
• Mercy Health Youngstown LLC

  • General Acute Care Hospital
  • Youngstown, OH
  • NPI 1790868982

  Hospital

  Care Compare affiliation
• Mercy Health Youngstown LLC

  • Clinical Medical Laboratory
  • Youngstown, OH
  • NPI 1831600295

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1368576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1609212869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "305-628-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5264 LEE RD",
            "city": "MAPLE HEIGHTS",
            "state": "OH",
            "postal_code": "441371232",
            "telephone_number": "305-628-6117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "667 Eastland Ave SE",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "OH",
            "postal_code": "444844503",
            "country_code": "US",
            "telephone_number": "330-841-2378",
            "fax_number": "330-729-1591",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1044 Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445041006",
            "country_code": "US",
            "telephone_number": "330-480-7320",
            "fax_number": "330-729-1591",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8401 Market St",
            "address_purpose": "LOCATION",
            "city": "Boardman",
            "state": "OH",
            "postal_code": "445126725",
            "country_code": "US",
            "telephone_number": "330-729-4298",
            "fax_number": "330-729-1897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "TAJUL",
        "name_prefix": "Mr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-15",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35.129571",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.129571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alveria Jackson, LPN
• Jessien Jackson
• Shawnda Trenay Jackson, LPN
• Anthony L Jacobs I

• All providers in Maple Heights, OH
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.