Individual provider Active NPI

Jubril Adeyemi Bishi, D.P.T

  • Physical Therapist
  • Bronx, NY
National Provider Identifier
1598866410
Registry record updated Sep 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
016546-1 Issued in NY
Practice address
1775 Grand Concourse
6TH Floor
Bronx, NY 10453-8202
Phone
(718) 579-3940
Fax
(718) 518-5818
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 016546-1 NY Primary

Addresses

Primary practice location

1775 Grand Concourse
6TH Floor
Bronx, NY 10453-8202

Mailing address

1775 Grand Concourse
6TH Floor
Bronx, NY 10453-8202
Phone (718) 579-3940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141027001932 NY Practitioner - Physical Therapist in Private Practice 5597999185 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016546-1NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System CurrentSince Mar 5, 1997 Accepting new patients
Bronxcare Health System CurrentSince Mar 5, 1997 Accepting new patients

Locations

1775 Grand Concourse
Fl 6
Bronx, NY 10453
Phone (718) 901-8110

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

Networks

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410912000000",
    "number": "1598866410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 GRAND CONCOURSE",
            "address_2": "6TH FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104538202",
            "telephone_number": "718-579-3940",
            "fax_number": "718-518-5818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 GRAND CONCOURSE",
            "address_2": "6TH FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104538202",
            "telephone_number": "718-579-3940",
            "fax_number": "718-518-5818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISHI",
        "first_name": "JUBRIL",
        "middle_name": "ADEYEMI",
        "name_prefix": "Mr.",
        "credential": "D.P.T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2014-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "016546-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.