Active NPI
Zulqar N Islam, MD
- Anesthesiology Physician
- Augusta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 12879
- Practice address
- 1120 15TH St
Augusta, GA 30912-0006 - Phone
- (770) 337-5602
- NPI assigned
- Jun 5, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 12879 | GA | Primary |
Addresses
Primary practice location
1120 15TH St
Augusta, GA 30912-0006
Mailing address
1120 15TH St
Augusta, GA 30912-0006
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Medical College of Georgia School of Medicine, 2021
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 702-1806
Hospital & facility affiliations
- Wellstar Cobb Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12879 | GA | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mak Anesthesia Georgia, LLC | Anesthesiology | Current | Accepting new patients |
| Mak Anesthesia Holdings LLC | Anesthesiology | Current | Accepting new patients |
Locations
3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752
895 Canton Rd NE
Bldg 200
Marietta, GA 30060
Phone (678) 784-0203
3000 Hospital Blvd
Roswell, GA 30076
Phone (770) 751-2500
4500 Hospital Blvd
Ste 210
Roswell, GA 30076
5995 Barfield Rd
Sandy Springs, GA 30328
Phone (404) 256-1507
1100 Johnson Fy Rd NE
Ste 130
Sandy Springs, GA 30342
Phone (404) 531-9988
4441 Atlanta Rd SE
Ste 312
Smyrna, GA 30080
Phone (470) 956-4200
2306 Wisteria Dr
Ste 100
Snellville, GA 30078
Phone (770) 979-8200
2131 Fountain Dr
Snellville, GA 30078
Phone (770) 736-2225
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- Kennesaw, GA
- NPI 1912452939
-
- Anesthesiology Physician
- Kennesaw, GA
- NPI 1609390103
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Austell, GA
- NPI 1467420448
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622851200000",
"number": "1639746019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 15TH ST",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309120006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 15TH ST",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309120006",
"telephone_number": "770-337-5602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISLAM",
"first_name": "ZULQAR",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-05",
"last_updated": "2021-06-05",
"certification_date": "2021-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "GA",
"license": "12879",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2021; 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.