Mohammad Khayrul Islam, MD, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

SC007165 Issued in PA

Practice address

3554 Hulmeville Rd Ste 104
Bensalem, PA 19020-4366

Phone

(215) 245-1818

Fax

(215) 245-9129

NPI assigned

Jun 4, 2020

Last updated

Apr 8, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

New York College of Podiatric Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Foot and Ankle Specialists of Bucks County, LLCGroup PAC ID 3678852720, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mary Medical Center Hospital, Langhorne, PA, CCN 390258

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mislam3592996@direct.trinity-health.org

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.

• Foot and Ankle Specialists of Bucks County, LLC

  dba Steven Remus

  • Foot & Ankle Surgery Podiatrist
  • Bensalem, PA
  • NPI 1649720863
  Medicare reassignment Care Compare group NPD
• Foot and Ankle Specialists of Bucks County, LLC

  • Foot & Ankle Surgery Podiatrist
  • Langhorne, PA
  • NPI 1710425582
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Mary Medical Center

  • General Acute Care Hospital
  • Langhorne, PA
  • NPI 1780686931
  Care Compare affiliation

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1952925950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3554 HULMEVILLE RD STE 104",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190204366",
            "telephone_number": "215-245-1818",
            "fax_number": "215-245-9129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3554 HULMEVILLE RD STE 104",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190204366",
            "telephone_number": "215-245-1818",
            "fax_number": "215-245-9129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "MOHAMMAD",
        "middle_name": "KHAYRUL",
        "name_prefix": "Dr.",
        "credential": "MD, DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-04",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "105308",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC007165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Bensalem",
            "affiliation": "N",
            "address_1": "3554 Hulmeville Rd Ste 104",
            "city": "Bensalem",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190204366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Aisha Jackson, BCBA
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• Sandraliz Bercilla Jano
• Sat Pal Jassal, AU.D.

• Foot & Ankle Surgery Podiatrist in Bensalem, PA
• Providers in Bensalem, PA by specialty
• Foot & Ankle Surgery Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.