Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jonathan Alis

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1538547062

Dr. Jonathan Alis is a Diagnostic Radiology in Bronx, New York. Qualified in 2005, 21 years ago. Practices with Physician Affiliate Group of New York PC, a 1,224-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
21
Licensed in
NY
In the registry since
2015
Specialties on file
2
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Practice location Address checks out

1400 Pelham Pkwy S
Bronx, NY 10461-1138
Phone: (646) 243-2140
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 111 E 210th St, Bronx, NY 10467-2401 — (718) 920-4321

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 299005 (NY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1538547062
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 17, 2015
Last updated in NPPESAugust 14, 2020
Certification dateAugust 14, 2020
Mailing address111 E 210th St, Bronx, NY 10467-2401

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Physician Affiliate Group Of New York Pc — 1224 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Bronx