Individual provider Active NPI

Emily W Jiang

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1083254643
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
024562 Issued in NY
Practice address
1210 Webster Ave
Bronx, NY 10456-4208
Phone
(646) 859-0724
NPI assigned
Jan 13, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 024562 NY Primary

Addresses

Primary practice location

1210 Webster Ave
Bronx, NY 10456-4208

Mailing address

1210 Webster Ave
Bronx, NY 10456
Phone (917) 655-9577

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200331000279 NY Practitioner - Physician Assistant 8022447853 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2023 Accepting new patients
Fpa Hospital Based CurrentSince Apr 5, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2023 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: emily.jiang@ghuc.eclinicaldirectplus.com
  • Direct secure messaging: ejiang8535778@nychhc.direct-ci.com

Organizations & group practices 7

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": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1083254643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 WEBSTER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10456",
            "telephone_number": "917-655-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 WEBSTER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104564208",
            "telephone_number": "646-859-0724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIANG",
        "first_name": "EMILY",
        "middle_name": "W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-13",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "024562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.