NPIMap

Individual provider Active NPI

John Bishoy Bishara, D.O.

  • Pediatric Pulmonology Physician
  • Charleston, WV
National Provider Identifier
1891008033
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
3354 Issued in WV
Practice address
830 Pennsylvania Ave Ste 408
Charleston, WV 25302
Phone
(304) 388-1552
Fax
(304) 388-1565
NPI assigned
Jul 16, 2010
Last updated
Apr 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 3354 WV Primary
Pediatric Pulmonology Physician 2080P0214X 20A15272 CA

Addresses

Primary practice location

830 Pennsylvania Ave Ste 408
Charleston, WV 25302

Mailing address

830 Pennsylvania Ave
Ste 103
Charleston, WV 25302-3389
Phone (304) 388-1552

Other practice location 1

4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Phone (323) 660-2450

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jbishara126629@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address jbishara126629@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181029002338 WV Practitioner - Pulmonary DiseasePractitioner - Pediatric Medicine 6406113513 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Pediatric Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-7823

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A15272CAMDPediatric Pulmonology Physician
15272CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Aug 19, 2019 Accepting new patients
Montgomery General Hospital, Inc CurrentSince Aug 1, 2023 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Aug 19, 2019 Accepting new patients
Pocahontas Memorial Hospital CurrentSince Jun 13, 2022 Accepting new patients
Montgomery General Hospital, Inc CurrentSince Aug 1, 2023 Accepting new patients
Pocahontas Memorial Hospital Current Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

150 Duncan Rd
Buckeye, WV 24924
Phone (304) 799-7400

3200 Maccorkle Ave SE
#C
Charleston, WV 25304
Phone (304) 347-1336

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

800 Pennsylvania Ave
Charleston, WV 25302
Phone (304) 388-2550

830 Pennsylvania Ave
Ste 103
Charleston, WV 25302
Phone (304) 388-2525

830 Pennsylvania Ave
Ste 408
Charleston, WV 25302
Phone (304) 342-7780

401 6th Ave
Montgomery, WV 25136
Phone (304) 442-5151

Organizations & group practices 7

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.

Hospital & facility affiliations 11

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": "1279238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1891008033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 PENNSYLVANIA AVE",
            "address_2": "STE 103",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253023389",
            "telephone_number": "304-388-1552",
            "fax_number": "304-388-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 PENNSYLVANIA AVE STE 408",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25302",
            "telephone_number": "304-388-1552",
            "fax_number": "304-388-1565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4650 W Sunset Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900276062",
            "country_code": "US",
            "telephone_number": "323-660-2450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BISHARA",
        "first_name": "JOHN",
        "middle_name": "BISHOY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-16",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "WV",
            "license": "3354",
            "primary": true
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "CA",
            "license": "20A15272",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbishara126629@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 Pennsylvania Ave",
            "city": "Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253023351",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbishara126629@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 Pennsylvania Ave",
            "city": "Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253023351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.