NPIMap

Individual provider Active NPI

MD. Wahidul Islam, MD

  • Internal Medicine Physician
  • Fairfield, OH
National Provider Identifier
1699717504
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35077851 Issued in OH
Practice address
544 Patterson Blvd
Fairfield, OH 45014-2514
Phone
(513) 896-9595
Fax
(513) 896-4171
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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 35077851 OH Primary

Addresses

Primary practice location

544 Patterson Blvd
Fairfield, OH 45014-2514

Mailing address

5150 Sandy LN
Fairfield, OH 45014-2738
Phone (513) 874-8111

Other practice location 1

5150 Sandy LN
Fairfield, OH 45014-2738
Phone (513) 874-8111

Other identifiers 1

IdentifierTypeStateIssuer
2191168MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20050322001230 OH Practitioner - Internal Medicine 5799731857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health Physicians Cincinnati LLCGroup PAC ID 6709790892, 191 clinicians
Oxford Physical Therapy and RehabilitationGroup PAC ID 0244232874, 432 clinicians

Practice addresses (Care Compare)

5150 Sandy LN
Fairfield, OH 45014-2738
Phone (513) 896-9595

7567 Central Parke Blvd
A
Mason, OH 45040-6852

Hospital & facility affiliations

  • American Mercy Home Care, LLC Home health agency, Cincinnati, OH, CCN 367167
  • Mercy Health - West Hospital Hospital, Cincinnati, OH, CCN 360234
  • Mercy Health - Fairfield Hospital Hospital, Fairfield, OH, CCN 360056
  • Bethesda North Hospital, Cincinnati, OH, CCN 360179
  • The Jewish Hospital-Mercy Health Hospital, Cincinnati, OH, CCN 360016
  • Fort Hamilton Hughes Memorial Hospital Hospital, Hamilton, OH, CCN 360132

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35077851OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Cincinnati, LLC Internal Medicine CurrentSince Jan 5, 2009 Accepting new patients
Mercy Health Physicians Cincinnati LLC CurrentSince Jan 5, 2009 Accepting new patients

Locations

2446 Kipling Ave
Cincinnati, OH 45239
Phone (513) 583-8500

1701 Mercy Health Pl
Cincinnati, OH 45237
Phone (513) 952-5000

5150 Sandy Ln
Fairfield, OH 45014
Phone (513) 645-1125

544 Patterson Blvd
Fairfield, OH 45014
Phone (513) 896-9595

12029 Sheraton Ln
Springdale, OH 45246
Phone (513) 874-8111

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 7

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1699717504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 SANDY LN",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450142738",
            "telephone_number": "513-874-8111",
            "fax_number": "513-860-6992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 PATTERSON BLVD",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450142514",
            "telephone_number": "513-896-9595",
            "fax_number": "513-896-4171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5150 SANDY LN",
            "address_purpose": "LOCATION",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450142738",
            "country_code": "US",
            "telephone_number": "513-874-8111",
            "fax_number": "513-860-6992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "MD. WAHIDUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35077851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2191168",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.