Mohammed N. Islam, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

MD436442 Issued in PA

Practice address

1265 Wayne Ave
119 Prof. BLDG, Suite 103
Indiana, PA 15701-3501

Phone

(724) 463-1046

Fax

(724) 463-2314

NPI assigned

Sep 20, 2006

Last updated

Aug 23, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Vascular SurgeryAlso: General Surgery

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medex Diagnostic and Treatment Center LLCGroup PAC ID 1456336445, 26 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Medex Diagnostic and Treatment Center LLC

  • Clinic/Center
  • Forest Hills, NY
  • NPI 1629001102
  Medicare reassignment Care Compare group NPD
• American Medical Today P.C.

  • General Practice Physician
  • Brooklyn, NY
  • NPI 1710471800
  Medicare reassignment NPD
• Sinai Diagnostics and Interventional Radiology, P.C.

  • Specialist
  • Brooklyn, NY
  • NPI 1619096484
  Medicare reassignment NPD
• Total Care Radiology PC

  dba Astra Vein & Endovascular Medical Care

  • Ambulatory Surgical Clinic/Center
  • Brooklyn, NY
  • NPI 1346865227
  Medicare reassignment NPD
• Brookhaven Surgical Services PC

  • Surgery Physician
  • Patchogue, NY
  • NPI 1316121973
  NPD (past)
• Imtiyaz I Kapadwala DPM PC

  • Specialist
  • Brooklyn, NY
  • NPI 1134199599
  NPD (past)
• Medical Office PC

  • Primary Care Clinic/Center
  • Staten Island, NY
  • NPI 1225002785
  NPD (past)
• Sen Medical Care PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brooklyn, NY
  • NPI 1467948943
  NPD (past)
• Syed Tamkin Ahmad MD PC

  • Internal Medicine Physician
  • Hempstead, NY
  • NPI 1497942577
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314057600000",
    "number": "1750488631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 NORTH 7TH STREET",
            "address_2": "SUITE 203",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157011880",
            "telephone_number": "724-357-7196",
            "fax_number": "724-357-7279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 WAYNE AVE",
            "address_2": "119 PROF. BLDG, SUITE 103",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013501",
            "telephone_number": "724-463-1046",
            "fax_number": "724-463-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "MOHAMMED",
        "middle_name": "N.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD436442",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "MD436442",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "195804",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01663309",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather I Irene, MS, LBS
• Irmc BHS Multispecialty Physician Group (IRMC Cardiology Associates)
• Irmc Urgicare at Indiana
• Irmc/BHS Multispecialty Physician Group Inc
• Rebekah Isenberg
• Ruslan Ivanov, MA
• Bethany Vernocy Jablunovsky, PA
• Monica Lynn Jacobs, MED, LPC
• Jamil Ahmed MD PC
• Jano Radiation Oncology Group PC

• Vascular Surgery Physician in Indiana, PA
• Providers in Indiana, PA by specialty
• Vascular Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; 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.

Verify at the official NPI Registry.