Active NPI
Islam Abbas Bolad, MD
- Cardiovascular Disease Physician
- Lafayette, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 01064026A
- Practice address
- 3900 St Francis Way Ste 200
Lafayette, IN 47905-4940 - Phone
- (765) 775-2800
- Fax
- (765) 775-2831
- NPI assigned
- Dec 14, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 01064026A | IN | |
| Interventional Cardiology Physician | 207RI0011X | 016813 | ME | |
| Cardiovascular Disease Physician | 207RC0000X | 01064026A | IN | Primary |
Addresses
Primary practice location
3900 St Francis Way Ste 200
Lafayette, IN 47905-4940
Mailing address
PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800
Other practice location 1
1481 W 10th St
Indianapolis, IN 46202-2803
Phone (317) 988-2501
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200881960 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- 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
- Cardiovascular Disease (Cardiology)
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3900 St Francis Way
Suite 200
Lafayette, IN 47905-4923
Phone (765) 463-2399
Hospital & facility affiliations
- Franciscan Health Lafayette
- Franciscan Health Crawfordsville
- Franciscan Health Rensselaer, Inc
- Memorial Hospital
- Franciscan Health Indianapolis
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01064026A | IN | MD | Cardiovascular Disease Physician |
| 016813 | ME | MD | Interventional Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Franciscan Physician Network | Internal Medicine | Current | Accepting new patients |
| Franciscan Physician Network | Current | Accepting new patients |
Locations
1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120
1710 Lafayette Rd
Crawfordsvlle, IN 47933
Phone (765) 362-2800
3900 St Francis Way
Ste 200
Lafayette, IN 47905
Phone (765) 775-2800
1104 E Grace St
Rensselaer, IN 47978
Phone (219) 866-2026
150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211
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.
-
- Family Medicine Physician
- Indianapolis, IN
- NPI 1225327984
Internal Medicine
-
- Internal Medicine Physician
- Indianapolis, IN
- NPI 1861441537
-
- Clinic/Center
- Lafayette, IN
- NPI 1992543250
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Crawfordsville, IN
- NPI 1588774558
-
- General Acute Care Hospital
- Carmel, IN
- NPI 1376214981
-
- General Acute Care Hospital
- Indianapolis, IN
- NPI 1386749893
-
- General Acute Care Hospital
- Lafayette, IN
- NPI 1356435341
-
- Critical Access Hospital
- Rensselaer, IN
- NPI 1932589173
-
- General Acute Care Hospital
- Logansport, IN
- NPI 1356320469
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676592000000",
"number": "1780746198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 781076",
"city": "DETROIT",
"state": "MI",
"postal_code": "482781076",
"telephone_number": "317-528-4800",
"fax_number": "317-865-1479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900 ST FRANCIS WAY STE 200",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479054940",
"telephone_number": "765-775-2800",
"fax_number": "765-775-2831"
}
],
"practiceLocations": [
{
"address_1": "1481 W 10th St",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462022803",
"country_code": "US",
"telephone_number": "317-988-2501",
"fax_number": "317-988-3243",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOLAD",
"first_name": "ISLAM",
"middle_name": "ABBAS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-14",
"last_updated": "2023-02-17",
"certification_date": "2023-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "01064026A",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "ME",
"license": "016813",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "IN",
"license": "01064026A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200881960",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; 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.