Active NPI
Robert Tristian Isom, M.D.
- Nephrology Physician
- Portland, ME
National Provider Identifier
1356428072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- MD25822
- Practice address
- 1600 Congress St Ste B
Portland, ME 04102-2148 - Phone
- (207) 774-5222
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | MD25822 | ME | Primary |
| Nephrology Physician | 207RN0300X | 217627 | NY |
Addresses
Primary practice location
1600 Congress St Ste B
Portland, ME 04102-2148
Mailing address
1600 Congress St Ste B
Portland, ME 04102-2148
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02423449 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- Education
- Columbia University College of Physicians and Surgeons, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
917 Blanco Cir
Salinas, CA 93901-4446
Phone (831) 755-7999
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 217627 | NY | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Coast Nephrology Medical Corporation | Nephrology | Current | Accepting new patients |
| Stanford Health Care | Past | Accepting new patients | |
| Trustees of Columbia University in the City of Ny | Past | Accepting new patients |
Locations
8095 Camino Arroyo
#200
Gilroy, CA 95020
Phone (408) 847-2200
917 Blanco Cir
Salinas, CA 93901
Phone (831) 755-7999
Interoperability endpoints
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
- risom18248@direct.svmh.com
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
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.
-
- Nephrology Physician
- Salinas, CA
- NPI 1366550675
-
- General Acute Care Hospital
- Stanford, CA
- NPI 1437292927
-
- Internal Medicine Physician
- New York, NY
- NPI 1043447253
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Monterey, CA
- NPI 1679562169
-
- General Acute Care Hospital
- Monterey, CA
- NPI 1932197258
-
- General Acute Care Hospital
- Hollister, CA
- NPI 1275578817
-
- Rural Health Clinic/Center
- Gonzales, CA
- NPI 1437549284
Hospital
-
- General Acute Care Hospital
- Salinas, CA
- NPI 1750384079
-
- Critical Access Hospital
- King City, CA
- NPI 1114917564
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653350400000",
"number": "1356428072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 CONGRESS ST STE B",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041022148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 CONGRESS ST STE B",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041022148",
"telephone_number": "207-774-5222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISOM",
"first_name": "ROBERT",
"middle_name": "TRISTIAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2022-05-24",
"certification_date": "2022-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "ME",
"license": "MD25822",
"primary": true
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "NY",
"license": "217627",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02423449",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.