Individual provider Active NPI

Kaijun Huang, M.D.

  • Internal Medicine Physician
  • Flushing, NY
National Provider Identifier
1043622814
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
296434 Issued in NY
Practice address
13620 Maple Ave Ste C502
Flushing, NY 11355-5166
Phone
(917) 423-7232
NPI assigned
May 28, 2014
Reactivated
Sep 16, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 296434 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

13620 Maple Ave Ste C502
Flushing, NY 11355-5166

Mailing address

13620 Maple Ave Ste C502
Flushing, NY 11355-5166
Phone (917) 423-7323

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190326000912 NY Practitioner - Internal Medicine 1951646199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

13620 Maple Ave
Suite C502
Flushing, NY 11355-5166
Phone (516) 407-0401

National Provider Directory

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

Organizations & group practices 1

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": "1401235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1043622814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13620 MAPLE AVE STE C502",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555166",
            "telephone_number": "917-423-7323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13620 MAPLE AVE STE C502",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555166",
            "telephone_number": "917-423-7232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUANG",
        "first_name": "KAIJUN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-28",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "deactivation_date": "2024-09-06",
        "reactivation_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "296434",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.