Individual provider Active NPI

Tom Jose, M.D

  • Internal Medicine Physician
  • Youngstown, OH
National Provider Identifier
1174958698
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2016-01727 Issued in NC
Practice address
500 Gypsy LN
Youngstown, OH 44504-1315
Phone
(330) 881-8253
NPI assigned
Sep 4, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2016-01727 NC Primary

Addresses

Primary practice location

500 Gypsy LN
Youngstown, OH 44504-1315

Mailing address

5221 Paramount Pkwy Ste 220
Morrisville, NC 27560-5490

Other practice location 1

100 Airport Rd Fl 4
Kinston, NC 28501-1604
Phone (252) 522-7197

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tjose287066@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161026000028 NC Practitioner - Internal Medicine 3476842311 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians
Unc Physicians Network LLCGroup PAC ID 5496940546, 985 clinicians

Practice addresses (Care Compare)

100 Airport Rd
Kinston, NC 28501-1604
Phone (252) 522-7197

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514-2601
Phone (919) 942-5123

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of North Carolina - Rocky Mount Internal Medicine CurrentSince Sep 1, 2019 Accepting new patients
Cogent Healthcare of North Carolina, PC Internal Medicine CurrentSince Sep 1, 2019 Accepting new patients
Unc Physicians Network LLC Current Accepting new patients
Vidant Medical Group LLC CurrentSince Aug 29, 2016 Accepting new patients
Unc Physicians Network LLC Internal Medicine CurrentSince Sep 18, 2022 Accepting new patients
Hospitalist Medicine Physicians of North Carolina PLLC Internal Medicine CurrentSince Sep 1, 2019 Accepting new patients

Locations

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

262 Leroy George Dr
Clyde, NC 28721
Phone (828) 452-8210

317 Western Blvd
Jacksonville, NC 28546
Phone (910) 577-2240

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

100 Airport Rd
Fl 4
Kinston, NC 28501
Phone (252) 522-7197

100 Airport Rd
Kinston, NC 28501
Phone (252) 522-7000

5221 Paramount Pkwy
Ste 220
Morrisville, NC 27560
Phone (984) 215-4110

2460 Curtis Ellis Dr
Rocky Mount, NC 27804
Phone (252) 443-8199

Interoperability endpoints

  • Direct secure messaging: tjose287066@direct.unc.nchie.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1174958698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5221 PARAMOUNT PKWY STE 220",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275605490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 GYPSY LN",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041315",
            "telephone_number": "330-881-8253"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Airport Rd Fl 4",
            "address_purpose": "LOCATION",
            "city": "Kinston",
            "state": "NC",
            "postal_code": "285011604",
            "country_code": "US",
            "telephone_number": "252-522-7197",
            "fax_number": "252-522-7288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOSE",
        "first_name": "TOM",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-04",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2016-01727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tjose287066@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "100 Airport Rd Fl 4",
            "city": "Kinston",
            "state": "NC",
            "country_code": "US",
            "postal_code": "285011604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.