Riazul Islam, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810008546 Issued in VA

Practice address

2680 Opitz Blvd Ste 220
Woodbridge, VA 22192-6821

Phone

(703) 497-1771

NPI assigned

Aug 19, 2024

Last updated

Aug 19, 2024By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Woodbridge Therapy Group LLCGroup PAC ID 0840547824, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Woodbridge Therapy Group LLC

  • Psychologist
  • Woodbridge, VA
  • NPI 1427421627

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1770315715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16934 MONMOUTH CT",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220263252",
            "telephone_number": "757-705-6557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 OPITZ BLVD STE 220",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221926821",
            "telephone_number": "703-497-1771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8140 Ashton Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Manassas",
            "state": "VA",
            "postal_code": "201095701",
            "country_code": "US",
            "telephone_number": "703-330-9933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "RIAZUL",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810008546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audrey Shanae Isaacs, MSW
• Isada Healthcare Services, Inc.
• Christelle Isambo
• Isk Services LLC
• Giovanna Zoila Isla
• Lawrence J Israel, MD
• Fatmata Mohammed Jabbie, RN
• Richard A. Jablonski, O.D.
• Walter Jachimowicz
• Brian Jackson, OTD

• Clinical Psychologist in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.