MR. SAMEEN ISLAM PA-C
NPI 1386375061
Student in an Organized Health Care Education/Training Program in New Haven, CT

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since June 22, 2022PECOS Enrolled

100 CHURCH ST S, NEW HAVEN, CT 06519(844) 433-9253 Get Directions Write a Review

NPPES record last updated: June 22, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Mr. Sameen Islam Pa-c NPPES

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

MR. SAMEEN ISLAM PA-C (NPI 1386375061) is an individual student in an organized health care education/training program in New Haven, Connecticut and active in the NPI registry since June 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1386375061

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameMR. SAMEEN ISLAMCredential: PA-C

Location Address100 CHURCH ST SNew Haven, CT 06519-1703

Mailing Address100 Church St S Ste A230New Haven, CT 06519-1703

Phone(844) 433-9253

Sole ProprietorYes

Enumeration DateJune 22, 2022

NPPES CertifiedJune 22, 2022

✔ NPI 1386375061 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.

100 CHURCH ST S, New Haven, CT 06519

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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)

Mr. Sameen Islam Pa-c 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.