Shon Anthony Isaacs Jr.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

900974 Issued in NY

Practice address

1380 Chicago Ave
Bay Shore, NY 11706-4608

Phone

(631) 383-4708

NPI assigned

Jan 8, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1245000397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 CHICAGO AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117064608",
            "telephone_number": "631-383-4708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 CHICAGO AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117064608",
            "telephone_number": "631-383-4708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISAACS",
        "first_name": "SHON",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "900974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edmund Salvatore Ippolito
• Abbas Ali Iqbal
• Craig Irby I
• Tochi Iroku-Malize, MD
• Miriam Isaacs, RN
• Island Heart Associates, LLP
• Island Nephrology Consultants, P.C.
• Island Regional Physical Therapy PLLC
• Island Shore Physical Therapy LLP
• Island Surgical & Vascular Group, P.C.

• Registered Nurse in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.