Jung San Shen, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

25MA02834800 Issued in NJ

Practice address

219 S Broad St
Elizabeth, NJ 07202-3453

Phone

(908) 352-5927

Fax

(908) 352-6181

NPI assigned

Sep 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Cardiology Services of Elizabeth

  • Cardiovascular Disease Physician
  • Elizabeth, NJ
  • NPI 1235160839
  NPD (past)
• Trinitas Regional Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cranford, NJ
  • NPI 1518423698
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053411272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 S BROAD ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072023453",
            "telephone_number": "908-352-5927",
            "fax_number": "908-352-6181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 S BROAD ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072023453",
            "telephone_number": "908-352-5927",
            "fax_number": "908-352-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEN",
        "first_name": "JUNG",
        "middle_name": "SAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MA02834800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2112701",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharma Optics LLC
• Lucy Mukta Sharma
• Rekha Sharma, M.D.
• Nardeen N Shehata, RPH
• Edward Shen, MD
• Clark Sherer, MD
• Anne Kate Sherman, LSW
• Young Kyu Shin
• Pranav Sanjay Shukla, MD
• Russ Honor Shulkes, LSW

• Pulmonary Disease Physician in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Pulmonary Disease Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.