Individual provider Active NPI

Ismat Hossain, M.D.

  • Internal Medicine Physician
  • Lake Worth, FL
National Provider Identifier
1619918141
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME90926 Issued in FL
Practice address
3898 Via Poinciana
Suite 19
Lake Worth, FL 33467-2951
Phone
(561) 619-6480
Fax
(561) 619-6418
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME90926 FL Primary

Addresses

Primary practice location

3898 Via Poinciana
Suite 19
Lake Worth, FL 33467-2951

Mailing address

3898 Via Poinciana
Ste 19
Lake Worth, FL 33467-2951
Phone (561) 619-6480

Other identifiers 1

IdentifierTypeStateIssuer
271600300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20050730000121 FL Practitioner - Internal Medicine 2567490683 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Accountable Care Hospitalist GroupGroup PAC ID 3678733342, 119 clinicians

Practice addresses (Care Compare)

5301 S Congress Ave
Atlantis, FL 33462-1149
Phone (561) 965-7300

Hospital & facility affiliations

  • Wellington Regional Medical Center Hospital, Wellington, FL, CCN 100275

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME90926FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Group of the Palm Beaches PA Internal Medicine CurrentSince Mar 30, 2022 Accepting new patients
Accountable Care Hospitalist Group Internal Medicine CurrentSince Aug 12, 2019 Accepting new patients

Locations

21644 State Road 7
Boca Raton, FL 33428
Phone (561) 488-8210

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

10101 Forest Hill Blvd
West Palm Beach, FL 33414
Phone (561) 766-1301

1155 S Congress Ave
Ste C
West Palm Beach, FL 33406
Phone 5617661300601

1626 Davis Rd
West Palm Beach, FL 33406
Phone (561) 265-3525

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1619918141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3898 VIA POINCIANA",
            "address_2": "STE 19",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334672951",
            "telephone_number": "561-619-6480",
            "fax_number": "561-619-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3898 VIA POINCIANA",
            "address_2": "SUITE 19",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334672951",
            "telephone_number": "561-619-6480",
            "fax_number": "561-619-6418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSSAIN",
        "first_name": "ISMAT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME90926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271600300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

Verify at the official NPI Registry.