Individual provider Active NPI

Miho Jo

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1518311596
Registry record updated Apr 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F340086 Issued in NY
Practice address
100 E 77TH St
New York, NY 10075-1850
Phone
(212) 434-2000
NPI assigned
Apr 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F340086 NY Primary

Addresses

Primary practice location

100 E 77TH St
New York, NY 10075-1850

Mailing address

150 50TH Ave Apt 1138
Long Island City, NY 11101-6078

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
I20161123000853 NY Practitioner - Nurse Practitioner 6002195690 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Nyc Medical Infusion PCGroup PAC ID 3678834157, 12 clinicians
Civic Medicine, PLLCGroup PAC ID 0345660254, 9 clinicians

Practice addresses (Care Compare)

1644 Eastchester Rd
Bronx, NY 10461-2316
Phone (212) 776-9090

400 Columbus Ave
Suite 105S
Valhalla, NY 10595-1368
Phone (203) 883-0038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F340086NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Civic Medicine, PLLC CurrentSince Oct 1, 2023 Accepting new patients
Nyc Medical Infusion PC CurrentSince Dec 25, 2018 Accepting new patients
Civic Wilton, PLLC PastSince Oct 1, 2023 Accepting new patients

Locations

249 Danbury Rd
Wilton, CT 06897
Phone (203) 762-3353

1365 Washington Ave
Ste 102A
Albany, NY 12206
Phone (518) 453-9220

50 Pennsylvania Ave
Binghamton, NY 13903
Phone (607) 772-0656

1644 Eastchester Rd
Bronx, NY 10461
Phone (917) 445-9119

1646 Eastchester Rd
Bronx, NY 10461
Phone (212) 249-8202

26 Court St
Ste 1210
Brooklyn, NY 11242
Phone (347) 353-3502

5663 E Circle Dr
Cicero, NY 13039
Phone (315) 214-0004

546 Towne Dr
Fayetteville, NY 13066

279 Main St
Ste 103
New Paltz, NY 12561
Phone (845) 255-9700

175 E 96th St
New York, NY 10128
Phone (212) 426-1970

1140 Broadway
New York, NY 10001
Phone (516) 941-6824

5225 Nesconset Hwy
Ste 36
Port Jefferson Station, NY 11776
Phone (631) 928-4870

1865 S Clinton Ave
Ste 160
Rochester, NY 14618

999 E Ridge Rd
Ste 13
Rochester, NY 14621

78 Todt Hill Rd
Ste 110
Staten Island, NY 10314
Phone (718) 227-5505

175 Jericho Tpke
Ste 312
Syosset, NY 11791
Phone (212) 246-3873

400 Columbus Ave
Ste 105S
Valhalla, NY 10595
Phone (203) 883-0038

400 Columbus Ave
Valhalla, NY 10595
Phone (203) 883-0038

2 Westchester Park Dr
Ste 101A
White Plains, NY 10604

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460678400000",
    "number": "1518311596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 50TH AVE APT 1138",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111016078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 77TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751850",
            "telephone_number": "212-434-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JO",
        "first_name": "MIHO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-15",
        "last_updated": "2016-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F340086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.