NPIMap

Individual provider Active NPI

Nazrul Islam, M.D.

  • Internal Medicine Physician
  • Macon, GA
National Provider Identifier
1629202841
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A102426 Issued in CA
Practice address
5398 Thomaston Rd
Macon, GA 31220-8110
Phone
(478) 476-8868
NPI assigned
May 4, 2009
Last updated
Sep 18, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

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 A102426 CA Primary

Addresses

Primary practice location

5398 Thomaston Rd
Macon, GA 31220-8110

Mailing address

3114 W Beverly Blvd
Montebello, CA 90640-2217
Phone (310) 408-7804

Other names 1

  • Dr. Mohammad Nazrul Islam Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140204000234 CA Practitioner - Internal Medicine 5890958631 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Group of Montebello IncGroup PAC ID 2264715143, 55 clinicians
Im-FSR IncGroup PAC ID 6901035138, 28 clinicians

Practice addresses (Care Compare)

1701 Santa Anita Ave
S El Monte, CA 91733-3411
Phone (626) 579-7777

2701 S Bristol St
Santa Ana, CA 92704-6201
Phone (714) 754-5454

3114 W Beverly Blvd
Montebello, CA 90640-2217
Phone (323) 726-3868

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A102426CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Houston Medical Associates, LLC Internal Medicine Current Accepting new patients
Im-FSR Inc. CurrentSince Jun 1, 2025 Accepting new patients
Hospitalist Group of Montebello Inc CurrentSince Aug 1, 2023 Accepting new patients
Internal Medicine MDS Corp Internal Medicine CurrentSince Jul 8, 2013 Accepting new patients

Locations

800 S Main St
Corona, CA 92882
Phone (909) 625-5411

3114 W Beverly Blvd
Montebello, CA 90640
Phone (323) 726-1317

2701 S Bristol St
Santa Ana, CA 92704
Phone (714) 636-0342

1701 Santa Anita Ave
South El Monte, CA 91733
Phone (626) 350-7916

2054 Watson Blvd
Warner Robins, GA 31093
Phone (478) 918-0770

Organizations & group practices 4

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 12

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": "1241395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1629202841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3114 W BEVERLY BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906402217",
            "telephone_number": "310-408-7804",
            "fax_number": "323-726-3870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5398 THOMASTON RD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312208110",
            "telephone_number": "478-476-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "NAZRUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-04",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A102426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOHAMMAD",
            "last_name": "ISLAM",
            "middle_name": "NAZRUL",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.