Individual provider Active NPI

Solomon Owusu, MD

  • Internal Medicine Physician
  • Jersey City, NJ
National Provider Identifier
1487723243
Registry record updated Feb 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA05988100 Issued in NJ
Practice address
559 W Side Ave
Jersey City, NJ 07304-1617
Phone
(201) 432-5300
Fax
(201) 432-4630
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA05988100 NJ Primary
Pediatrics Physician 208000000X 25MA05988100 NJ

Addresses

Primary practice location

559 W Side Ave
Jersey City, NJ 07304-1617

Mailing address

559 W Side Ave
Jersey City, NJ 07304-1617
Phone (201) 432-5300

Other identifiers 1

IdentifierTypeStateIssuer
6029612MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20050610000360 NJ Practitioner - Internal Medicine 5890738132 Practice locations: Jersey City, NJ

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

559 W Side Ave
Jersey City, NJ 07304-1617
Phone (201) 432-5300

Hospital & facility affiliations

  • Barnabas Health Home Care and Hospice Home health agency, West Orange, NJ, CCN 317061
  • Jersey City Medical Center Hospital, Jersey City, NJ, CCN 310074

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA05988100NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Hospital Opco LLC Current Accepting new patients
Jersey City Medical Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: solomon.owusu@neighborhoodc.ehi.direct-ci.com
  • Direct secure messaging: solomon.owusu@direct.christhospital.md

Organizations & group practices 2

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 3

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392076800000",
    "number": "1487723243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 W SIDE AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073041617",
            "telephone_number": "201-432-5300",
            "fax_number": "201-432-4630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 W SIDE AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073041617",
            "telephone_number": "201-432-5300",
            "fax_number": "201-432-4630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWUSU",
        "first_name": "SOLOMON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2014-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA05988100",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA05988100",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6029612",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.