NPIMap

Individual provider Active NPI

Jose Jessurun-Solomou, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • New York, NY
National Provider Identifier
1205928124
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
266154-1 Issued in NY
Practice address
525 E 68TH St
New York, NY 10065-4870
Phone
(212) 746-6481
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 266154-1 NY Primary

Addresses

Primary practice location

525 E 68TH St
New York, NY 10065-4870

Mailing address

525 E 68TH St
New York, NY 10065-4870
Phone (212) 746-6481

Other identifiers 10

IdentifierTypeStateIssuer
082727OtherMNFAIRIVEW
101360OtherMNU CARE
768180OtherARAZ
HP22292OtherMNHEALTH PARTNERS
661388800MedicaidMN
0038590MedicaidMT
11-00014OtherMNMEDICA-PRIMARY
4T513JEOtherMNBLUE CROSS BLUE SHIELD
1010329OtherMNPREFERRED ONE
1124548OtherMNMEDICA-CHOICE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120915000000 NY Practitioner - Pathology 9234035429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

525 E 68TH St
New York, NY 10065-4870
Phone (646) 962-3376

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
266154-1NYMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell CurrentSince Nov 1, 2017 Accepting new patients
Weill Medical College of Cornell CurrentSince Nov 1, 2017 Accepting new patients
Weill Medical College of Cornell Current Accepting new patients
University of Minnesota Physicians Past Accepting new patients

Locations

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

Organizations & group practices 4

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1205928124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870",
            "telephone_number": "212-746-6481",
            "fax_number": "212-746-6484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870",
            "telephone_number": "212-746-6481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSURUN-SOLOMOU",
        "first_name": "JOSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "266154-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAIRIVEW",
            "identifier": "082727",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U CARE",
            "identifier": "101360",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ",
            "identifier": "768180",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP22292",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "661388800",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0038590",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA-PRIMARY",
            "identifier": "11-00014",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4T513JE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1010329",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA-CHOICE",
            "identifier": "1124548",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.