Individual provider Active NPI

Isirikoufoulou Sibabi Akpo Kamou

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1295292894
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
023360 Issued in NY
Practice address
2902 3Rd Ave
Bronx, NY 10455-2601
Phone
(718) 571-9276
NPI assigned
Mar 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 023360 NY Primary

Addresses

Primary practice location

2902 3Rd Ave
Bronx, NY 10455-2601

Mailing address

3198 Grand Concourse
Bronx, NY 10458-1000
Phone (718) 618-0401

Other practice location 1

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 299-7295

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190612002279 NY Practitioner - Physician Assistant 1557694262 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Essen Medical Urgicare, PLLCGroup PAC ID 4385960897, 60 clinicians

Practice addresses (Care Compare)

1550 Dr Martin L King Jr Blvd
Bronx, NY 10452-1503
Phone (347) 269-2366

1990 McGraw Ave
Bronx, NY 10462-7908
Phone (646) 350-1616

2304 Eastchester Rd
Bronx, NY 10469-5911
Phone (347) 913-4333

2626 Halperin Ave
FL 1
Bronx, NY 10461-2631

3200 Grand Concourse
Bronx, NY 10458-1063
Phone (718) 561-3200

899 Elton Ave
Suite B
Bronx, NY 10451-4160
Phone (718) 638-7682

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
023360NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ag Urgent Care, P.C. PastSince Apr 30, 2023 Accepting new patients

Networks

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

Interoperability endpoints

  • Direct secure messaging: isirikoufoulou.akpokamou@ema.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1551398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1295292894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3198 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104581000",
            "telephone_number": "718-618-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2902 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104552601",
            "telephone_number": "718-571-9276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2015 Grand Concourse",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "10453",
            "country_code": "US",
            "telephone_number": "718-299-7295",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIBABI AKPO KAMOU",
        "first_name": "ISIRIKOUFOULOU",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-01",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "023360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.