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MOHAMMAD ISLAM
NPI 1003268095
Internal Medicine - Pulmonary Disease in Newark, OH

Active since July 01, 2016PECOS EnrolledAccepts Medicare Assignment
79.35/100
CMS Quality Rating
1272 W MAIN ST STE 503, NEWARK, OH 43055(220) 564-1805(220) 564-1806 Get Directions Write a Review

NPPES record last updated: December 9, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 9, 2022, Jul 1, 2016 (2 updates tracked since 2016).

About Mohammad Islam NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOHAMMAD ISLAM (NPI 1003268095) is an individual pulmonary disease provider in Newark, Ohio, licensed in Ohio (35.145446) and active in the NPI registry since July 2016. He is enrolled in Medicare PECOS, is affiliated with Knox Community Hospital, and is a graduate of Other (2011).

NPPES Registry Identity

NPI1003268095
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameMOHAMMAD ISLAM
Location Address1272 W MAIN ST STE 503Newark, OH 43055-2058
Mailing Address1320 W Main StNewark, OH 43055-1822 · (220) 564-4027
Phone(220) 564-1805
Fax(220) 564-1806
Sole ProprietorYes
Medical School CMSOtherGraduated 2011
Enumeration DateJuly 1, 2016
Last NPPES UpdateDecember 9, 20222 updates tracked since enumeration
NPPES CertifiedDecember 9, 2022
✔ NPI 1003268095 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License✔ Licensed in OH · 35.145446
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1272 W MAIN ST STE 503, Newark, OH 43055
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, MedMutual, Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mohammad Islam is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2860785144
PECOS Enrollment IDI20220629002248
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
196 services113 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
65 services58 patients
Test to examine how well the lungs exchange gases 94729
This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
51 services49 patients
Test to determine lung volumes using sensors 94726
This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.
48 services47 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
44 services44 patients
Test to measure expiratory airflow and volume changes before and after medication administration 94060
This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.
39 services39 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Knox Community Hospital

Acute Care Hospitals · Mount Vernon, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number360040
Location1330 Coshocton RoadMount Vernon, OH 43050 · Knox County
Emergency services Birthing friendly

Licking Memorial Hospital

Acute Care Hospitals · Newark, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360218
Location1320 West Main StreetNewark, OH 43055 · Licking County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43055 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

79.35/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality71.02
Promoting Interoperability100
Improvement Activities40
Cost57.85

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
3 suppliers13 claims14 services$39.01 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers16 claims16 services$69.53 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMILIA N. ANIGBO M.D.
Internal Medicine (Pulmonary Disease)
1272 W MAIN ST STE 503
NEWARK, OH 43055
Licking County (220) 564-1805
DR. MATTHEW R HARRIS DO
Family Medicine
1272 W MAIN ST STE 503
NEWARK, OH 43055
Licking County (220) 564-1778
OLUWATOYIN VICTORIA ADULOJU-ODUNAIYA
Nurse Practitioner
1272 W MAIN ST STE 503
NEWARK, OH 43055
Licking County (220) 564-1805
JAMES W DESAPRI
Family Medicine
1272 W MAIN ST STE 503
NEWARK, OH 43055
Licking County (220) 564-1788

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mohammad Islam's NPI number?

The NPI number for Mohammad Islam is 1003268095. It was assigned to this individual provider in the NPPES registry on July 1, 2016.

Where is Mohammad Islam located?

Mohammad Islam practices at 1272 W Main St Ste 503, Newark, OH 43055. The listed phone number is (220) 564-1805.

What is Mohammad Islam's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Mohammad Islam enrolled in Medicare?

Yes. Mohammad Islam is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Mohammad Islam accept?

Health plans from Anthem Blue Cross and Blue Shield, MedMutual and Molina Healthcare list Mohammad Islam as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Mohammad Islam affiliated with any hospitals?

According to CMS data, Mohammad Islam is affiliated with Knox Community Hospital and Licking Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Mohammad Islam was last updated on December 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.