NPIMap

Individual provider Active NPI

Shah Faizul Islam, M.D.

  • Nephrology Physician
  • Corpus Christi, TX
National Provider Identifier
1841293727
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
K8227 Issued in TX
Practice address
1521 S Staples St
Ste 601
Corpus Christi, TX 78404-3154
Phone
(361) 887-8451
Fax
(361) 887-6126
NPI assigned
May 24, 2005
Last updated
Apr 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X K8227 TX Primary

Addresses

Primary practice location

1521 S Staples St
Ste 601
Corpus Christi, TX 78404-3154

Mailing address

1521 S Staples St
Ste 601
Corpus Christi, TX 78404-3154
Phone (361) 887-8451

Other identifiers 1

IdentifierTypeStateIssuer
390006277MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address shah.islam@direct.davitaphysiciansolutions.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070416000129 TX Practitioner - Nephrology 9537066519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kidney Specialists of South Texas, P.a.Group PAC ID 0244203958, 9 clinicians

Practice addresses (Care Compare)

1521 S Staples St
Suite 601
Corpus Christi, TX 78404-3154
Phone (361) 887-8451

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney Specialists of South Texas, P.a. Nephrology CurrentSince Jul 1, 1999 Accepting new patients
Dialysis Access Center, LLP Nephrology PastSince Oct 30, 2022 Accepting new patients
Cardiovascular Care Providers, Inc. Past Accepting new patients
Christus Spohn Health System Corporation PastSince Jan 1, 2022 Accepting new patients

Locations

1315 Santa Fe St
Ste 102
Corpus Christi, TX 78404
Phone (361) 992-3500

1521 S Staples St
Ste 601
Corpus Christi, TX 78404
Phone (361) 887-8451

5826 Esplanade Dr
Ste 204
Corpus Christi, TX 78414
Phone (361) 994-4858

Interoperability endpoints

  • Direct secure messaging: shah.islam.1@19285.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Christus Spohn Hospital KlebergKingsville, TX, CCN 450163 Hospital Corporate Director Jan 1, 2022
Christus Spohn Hospital Corpus ChristiCorpus Christi, TX, CCN 450046 Hospital Corporate Director Jan 1, 2022
Christus Spohn Hospital AliceAlice, TX, CCN 450828 Hospital Corporate Director Jan 1, 2022
Christus Spohn Hospital Corpus ChristiCorpus Christi, TX, CCN 45T046 Hospital Corporate Director Jan 1, 2022
Christus Spohn Hospital BeevilleBeeville, TX, CCN 450082 Hospital Corporate Director Jan 1, 2022
Christus Spohn Family Health Center FreerFreer, TX, CCN 458855 Rural health clinic Corporate Director Jan 1, 2022

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1841293727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 S STAPLES ST",
            "address_2": "STE 601",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784043154",
            "telephone_number": "361-887-8451",
            "fax_number": "361-887-6126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 S STAPLES ST",
            "address_2": "STE 601",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784043154",
            "telephone_number": "361-887-8451",
            "fax_number": "361-887-6126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "SHAH",
        "middle_name": "FAIZUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "K8227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390006277",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shah.islam@direct.davitaphysiciansolutions.com",
            "affiliation": "N",
            "address_1": "1521 S Staples St",
            "address_2": "Ste 601",
            "city": "Corpus Christi",
            "state": "TX",
            "country_code": "US",
            "postal_code": "784043154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.