Individual provider Active NPI

Min Jo

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1538601315
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F339215 Issued in NY
Practice address
2015 Grand Concourse
Bronx, NY 10453-4303
Phone
(718) 299-7295
Fax
(718) 299-6797
NPI assigned
Nov 10, 2016
Last updated
Nov 10, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 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 F339215 NY Primary

Addresses

Primary practice location

2015 Grand Concourse
Bronx, NY 10453-4303

Mailing address

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

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
I20170131001025 NY Practitioner - Nurse Practitioner 0749562585 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F339215NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bronx Medical Practice P.C. CurrentSince Nov 23, 2016 Accepting new patients
Essen Medical Associates, PC CurrentSince Nov 23, 2016 Accepting new patients
Tcprnc, LLC CurrentSince Nov 29, 2017 Accepting new patients
Rockwell Health LLC CurrentSince Apr 29, 2024 Accepting new patients
Essen Medical Associates, PC CurrentSince Nov 23, 2016 Accepting new patients
Parcare Community Health Network Inc CurrentSince Sep 1, 2023 Accepting new patients
House Call Medical Services of New York, PLLC CurrentSince Nov 23, 2016 Accepting new patients
Tcprnc, LLC CurrentSince Nov 29, 2017 Accepting new patients
Parcare Community Health Network Inc CurrentSince Sep 1, 2023 Accepting new patients
Essen Medical Associates,PC Past Accepting new patients
Ilyagu Medical PC Past Accepting new patients

Locations

100 W Kingsbridge Rd
Bronx, NY 10468
Phone (718) 410-1480

1371 Seabury Ave
Bronx, NY 10461
Phone (718) 294-6200

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

1000 Gates Ave
Ste 5
Brooklyn, NY 11221

17 W 9th St
Brooklyn, NY 11231
Phone (718) 599-9090

202 Caton Ave
Brooklyn, NY 11218

445 Park Ave
Brooklyn, NY 11205
Phone (718) 965-1320

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HHFGDD

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1478736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1538601315",
    "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",
            "fax_number": "718-795-4394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534303",
            "telephone_number": "718-299-7295",
            "fax_number": "718-299-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JO",
        "first_name": "MIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-10",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F339215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.