JOHN BISHARA – Oral & Maxillofacial Surgery (D.M.D.), NPI 1508429622

JOHN BISHARA is a healthcare provider. based in New york, New York. specializing in ORAL SURGERY. They hold a License No. A202254 (CA). The NPI Number for JOHN BISHARA is 1508429622

Main info

Male
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
JOHN BISHARA
NPI
1508429622
Phone
(212) 241-3332
Address
1 GUSTAVE L LEVY PL
Enumeration Date
15 April 2019
Last Update Date
8 October 2025

Doctor Profile

Medical School Name
NEW YORK MEDICAL COLLEGE
Secondary Phone
5594594101
Graduation Year
2022 (4 years ago)
PAC ID
6507362506
Group Practice PAC ID
1052735552
Professional Enrollment ID
I20250930000635
Address ID
CA937012363FR215XXSTXX404
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness85
Years active:7State licenses:1Digital endpointsOther names

182 ORAL SURGERY in NY

Provider Addresses for JOHN BISHARA

  • 1 GUSTAVE L LEVY PL

    NEW YORK, NY 100296504

    Phone: (212) 241-3332

    Type: Location

  • 1 GUSTAVE L LEVY PL # 1076

    NEW YORK, NY 100296504

    Phone: (212) 241-6694

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-09-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250930000635IOral SurgeryCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 10029)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1052735552View full group profile
NameSpecialtyState
O T O L A R Y N G O L O G YPA
Oral Surgery, Plastic And Reconstructive SurgeryCA
Oral SurgeryCA
D E N T I S TCA
Maxillofacial Surgery, Oral SurgeryTX
Maxillofacial SurgeryCA

Reviews

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Frequently asked questions

How is JOHN BISHARA identified in CMS data?
CMS-hosted NPPES data lists JOHN BISHARA with NPI 1508429622.
Is JOHN BISHARA still practicing?
JOHN BISHARA is currently listed as active in the public NPI registry.
What is JOHN BISHARA's specialty?
The listing groups JOHN BISHARA with Oral & Maxillofacial Surgery (D.M.D.). Clinical services aligned with this taxonomy classification.
Does JOHN BISHARA list a practice location?
Patients near New York, New York may find JOHN BISHARA in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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