Individual provider Active NPI

Wun-Ye Jiu, M.D.

  • Specialist
  • Harrington Park, NJ
National Provider Identifier
1104025170
Registry record updated Jun 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
25MA07810800 Issued in NJ
Practice address
24 Elm St
Harrington Park, NJ 07640-1902
Phone
(201) 784-0123
Fax
(201) 784-0065
NPI assigned
Jul 11, 2007
Last updated
Jun 24, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 25MA07810800 NJ Primary

Addresses

Primary practice location

24 Elm St
Harrington Park, NJ 07640-1902

Mailing address

19 S Washington Ave
Bergenfield, NJ 07621-2324
Phone (201) 387-0177

Other identifiers 1

IdentifierTypeStateIssuer
P00362919OtherNJRAILROAD MDCR #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20060321000577 NJ Practitioner - Internal Medicine 4284641945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Icahn School of Medicine at Mount Sinai, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19 S Washington Ave
Bergenfield, NJ 07621-2324
Phone (201) 387-0177

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Am PM Primary Care CurrentSince Mar 19, 2014 Accepting new patients
Am PM Walk in Urgent Care Clinic PastSince Apr 1, 2013 Accepting new patients
The Park Medical Group, PA Specialist Past Accepting new patients
Greenwich Village Medical Group, PC Past Accepting new patients
Park Medical Group PA Specialist PastSince Feb 2, 2004 Accepting new patients

Locations

19 S Washington Ave
Bergenfield, NJ 07621
Phone (201) 387-0177

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466726400000",
    "number": "1104025170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 S WASHINGTON AVE",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076212324",
            "telephone_number": "201-387-0177",
            "fax_number": "201-387-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 ELM ST",
            "city": "HARRINGTON PARK",
            "state": "NJ",
            "postal_code": "076401902",
            "telephone_number": "201-784-0123",
            "fax_number": "201-784-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIU",
        "first_name": "WUN-YE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2016-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA07810800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MDCR #",
            "identifier": "P00362919",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrington Park, NJ

Sources for this page

Verify at the official NPI Registry.