Individual provider Active NPI

Jose Roberto Contreras Isussi, MD

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1194339531
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
325861 Issued in NY
Practice address
4487 3Rd Ave
Bronx, NY 10457-1526
Phone
(718) 960-9000
NPI assigned
Sep 2, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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 325861 NY Primary

Addresses

Primary practice location

4487 3Rd Ave
Bronx, NY 10457-1526

Mailing address

4487 3Rd Ave
Bronx, NY 10457-1526
Phone (718) 960-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240116003723 NY Practitioner - Internal Medicine 0345692240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SBH Physicians PCGroup PAC ID 3072798941, 178 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (718) 960-6205

2016 Bronxdale Ave
Bronx, NY 10462-3388
Phone (718) 822-1515

4422 3Rd Ave
Bronx, NY 10457-2545
Phone (718) 960-6214

4487 3Rd Ave
Bronx, NY 10457-1526
Phone (718) 960-6392

Hospital & facility affiliations

  • St Barnabas Hospital Hospital, Bronx, NY, CCN 330399

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
325861NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SBH Physicians, PC Internal Medicine CurrentSince Nov 22, 2023 Accepting new patients
SBH Physicians, PC CurrentSince Nov 22, 2023 Accepting new patients
St. Barnabas Hospital Past Accepting new patients

Locations

4487 3rd Ave
Bronx, NY 10457
Phone (718) 960-3730

111 E 210th St
Bronx, NY 10467

4422 3rd Ave
Bronx, NY 10457
Phone (718) 960-3917

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Organizations & group practices 3

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 1

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": "1599004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1194339531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4487 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104571526",
            "telephone_number": "718-960-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4487 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104571526",
            "telephone_number": "718-960-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONTRERAS ISUSSI",
        "first_name": "JOSE",
        "middle_name": "ROBERTO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-02",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "325861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.