Active NPI
Kazi M Islam, M.D.
- Pediatrics Physician
- Lansdowne, PA
National Provider Identifier
1982798302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD051940L
- Practice address
- 23 E la Crosse Ave
Lansdowne, PA 19050-2002 - Phone
- (610) 394-2130
- Fax
- (610) 394-2177
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD051940L | PA | Primary |
Addresses
Primary practice location
23 E la Crosse Ave
Lansdowne, PA 19050-2002
Mailing address
1025 Capie Polk Drive
Springfield, PA 19064
Phone (610) 544-1512
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1466911 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD051940L | PA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kazi M Islam MD & Associates | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- kazimislam@kazimislam.direct.emds.com
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560470400000",
"number": "1982798302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 CAPIE POLK DRIVE",
"city": "SPRINGFIELD",
"state": "PA",
"postal_code": "19064",
"telephone_number": "610-544-1512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 E LA CROSSE AVE",
"city": "LANSDOWNE",
"state": "PA",
"postal_code": "190502002",
"telephone_number": "610-394-2130",
"fax_number": "610-394-2177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISLAM",
"first_name": "KAZI",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2019-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD051940L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1466911",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lansdowne, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.