Active NPI
Caroline Leung, PA-C, RD
- Physician Assistant
- Corona, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 023295
- Practice address
- 3716 108TH St
Corona, NY 11368-2025 - Phone
- (718) 651-4000
- NPI assigned
- Aug 9, 2013
- Last updated
- Mar 12, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 023295 | NY | Primary |
| Registered Dietitian | 133V00000X | 1065954 | NY |
Addresses
Primary practice location
3716 108TH St
Corona, NY 11368-2025
Mailing address
1065 Southern Blvd
Bronx, NY 10459-2417
Phone (718) 589-2440
Other practice location 1
1065 Southern Blvd
Bronx, NY 10459-2417
Phone (718) 589-2440
Other practice location 2
14732 Jamaica Ave
Jamaica, NY 11435-4042
Phone (718) 443-1767
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: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1065954 | NY | MD | Registered Dietitian |
| 023295 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Caroline Leung Nutrition LLC | Dietitian, Registered | Current | Accepting new patients |
| Urban Health Plan, Inc. | Current | Accepting new patients | |
| Urban Health Plan, Inc. | Current | Accepting new patients | |
| Sun River Health Inc | Current | Accepting new patients | |
| Sun River Health Inc. | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Physician Assistant | Current | Accepting new patients |
| Urban Health Plan, Inc. | Current | Accepting new patients |
Locations
3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006
1065 Southern Blvd
Bronx, NY 10459
Phone 71858924404222
1515 Southern Blvd
#H
Bronx, NY 10460
Phone (718) 589-1600
3716 108th St
Corona, NY 11368
Phone (718) 651-4000
161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559
161 Fort Washington Ave
Fl 8
New York, NY 10032
Phone (212) 342-1155
622 W 168th St
New York, NY 10032
Phone (212) 305-4931
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- ckl9003@direct.nyp.org
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
Organizations & group practices 8
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.
-
- Federally Qualified Health Center (FQHC)
- Amenia, NY
- NPI 1568526838
-
- Federally Qualified Health Center (FQHC)
- Bronx, NY
- NPI 1265596548
-
- Registered Dietitian
- Middle Village, NY
- NPI 1194421750
Dietitian, Registered
-
- Surgery Physician
- New York, NY
- NPI 1508266347
-
- Federally Qualified Health Center (FQHC)
- Peekskill, NY
- NPI 1619969458
-
- Internal Medicine Physician
- New York, NY
- NPI 1699289488
Physician Assistant
-
dba Park Tree Community Health Center
- Federally Qualified Health Center (FQHC)
- Bronx, NY
- NPI 1386247542
-
dba Plaza del Sol Family Health Center
- Federally Qualified Health Center (FQHC)
- Corona, NY
- NPI 1710125141
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552348800000",
"number": "1073945390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1065 SOUTHERN BLVD",
"city": "BRONX",
"state": "NY",
"postal_code": "104592417",
"telephone_number": "718-589-2440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3716 108TH ST",
"city": "CORONA",
"state": "NY",
"postal_code": "113682025",
"telephone_number": "718-651-4000"
}
],
"practiceLocations": [
{
"address_1": "1065 Southern Blvd",
"address_purpose": "LOCATION",
"city": "Bronx",
"state": "NY",
"postal_code": "104592417",
"country_code": "US",
"telephone_number": "718-589-2440",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "14732 Jamaica Ave",
"address_purpose": "LOCATION",
"city": "Jamaica",
"state": "NY",
"postal_code": "114354042",
"country_code": "US",
"telephone_number": "718-443-1767",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEUNG",
"first_name": "CAROLINE",
"name_prefix": "Ms.",
"credential": "PA-C, RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-09",
"last_updated": "2019-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "023295",
"primary": true
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "1065954",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Corona, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.