Individual provider Active NPI

Raiyan Islam, DO

  • Student in an Organized Health Care Education/Training Program
  • Hudson, FL
National Provider Identifier
1649809302
Registry record updated Apr 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
14000 Fivay Rd
Hudson, FL 34667-7103
Phone
(727) 819-2966
Fax
(727) 819-2928
NPI assigned
Apr 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

14000 Fivay Rd
Hudson, FL 34667-7103

Mailing address

21322 Rockledge LN
Boca Raton, FL 33428-4877
Phone (561) 699-2995

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
I20240809002093 FL Practitioner - Internal Medicine 4183162092 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Accountable Teaching Services LLC CurrentSince Jul 1, 2024 Accepting new patients

Locations

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

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1586044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586044800000",
    "number": "1649809302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21322 ROCKLEDGE LN",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334284877",
            "telephone_number": "561-699-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14000 FIVAY RD",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346677103",
            "telephone_number": "727-819-2966",
            "fax_number": "727-819-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "RAIYAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-05",
        "last_updated": "2020-04-05",
        "certification_date": "2020-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, FL

Sources for this page

Verify at the official NPI Registry.