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DR. MAHJABEEN ISLAM M.D. NPI 1770606063


NPI Information

NPI: 1770606063
Provider Name: DR. MAHJABEEN ISLAM, M.D.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

CLIA Number: 36D0720976

Address:
959 ILLINOIS AVE STE E
MAUMEE, OH
ZIP 43537
Phone: (419) 872-0500
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DR. Mahjabeen Islam, M.D. is a family medicine in Maumee, OH with 42 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Mahjabeen Islam, M.D. NPI is 1770606063. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

959 ILLINOIS AVE STE E
MAUMEE, OH
ZIP 43537-744
Phone: (419) 872-0500
Fax: (419) 874-4650

The NPI 1770606063 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 36D0720976 - physician office with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Hemoglobin a1c level (HCPCS:83036)
  • Routine ekg using at least 12 leads including interpretation and report (HCPCS:93000)

The enumeration date for this NPI number is 4/9/2007 and was last updated on 1/24/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207QA0401XFamily MedicineAddiction MedicineOH053406OHIONo
2207Q00000XFamily Medicine35.053406OHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10696591MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.