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DR. BODRUL ISLAM MD
NPI 1205625977
Student in an Organized Health Care Education/Training Program in Detroit, MI

Active since May 01, 2025PECOS Enrolled
2799 W GRAND BLVD, DETROIT, MI 48202(313) 916-2600 Get Directions Write a Review

NPPES record last updated: May 1, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Bodrul Islam Md NPPES

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

DR. BODRUL ISLAM MD (NPI 1205625977) is an individual student in an organized health care education/training program in Detroit, Michigan and active in the NPI registry since May 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205625977
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. BODRUL ISLAMCredential: MD
Location Address2799 W GRAND BLVDDetroit, MI 48202-2608
Mailing Address2799 W Grand BlvdDetroit, MI 48202-2608
Phone(313) 916-2600
Sole ProprietorYes
Enumeration DateMay 1, 2025
NPPES CertifiedMay 1, 2025
✔ NPI 1205625977 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2799 W GRAND BLVD, Detroit, MI 48202
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Bodrul Islam Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 20

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

HENRY FORD HOSPITAL
General Acute Care Hospital
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600
DR. BRENT DAVID GRIFFITH M.D.
Radiology (Diagnostic Radiology)
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600
KANIKA KHANNA M.D
Radiology (Diagnostic Radiology)
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600
DR. FADL A CHOKR M.D.
Family Medicine
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600
AVI COHEN M.D.
Internal Medicine (Pulmonary Disease)
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600
LINDSEY AURORA
Internal Medicine (Cardiovascular Disease)
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600
KYLE KRUPA
Nurse Anesthetist, Certified Registered
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600
ALEXANDER GARBARINO
Internal Medicine (Pulmonary Disease)
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600

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 Bodrul Islam's NPI number?

The NPI number for Bodrul Islam is 1205625977. It was assigned to this individual provider in the NPPES registry on May 1, 2025.

Where is Bodrul Islam located?

Bodrul Islam practices at 2799 W Grand Blvd, Detroit, MI 48202. The listed phone number is (313) 916-2600.

What is Bodrul Islam's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Bodrul Islam enrolled in Medicare?

Yes. Bodrul Islam is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Bodrul Islam was last updated on May 1, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.