NPIMap

Individual provider Active NPI

Jiyeon Jung, MD

  • Internal Medicine Physician
  • Buffalo, NY
National Provider Identifier
1104075308
Registry record updated Jul 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
276106 Issued in NY
Practice address
1500 Broadway Ave
Buffalo, NY 14212-1845
Phone
(716) 893-8550
Fax
(716) 893-4020
NPI assigned
Sep 11, 2008
Last updated
Jul 14, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 276106 NY Primary

Addresses

Primary practice location

1500 Broadway Ave
Buffalo, NY 14212-1845

Mailing address

1500 Broadway Ave
Buffalo, NY 14212-1845
Phone (716) 893-8550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141128000032 NY Practitioner - Internal Medicine 3678752870 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2157 Main St
Buffalo, NY 14214-2648
Phone (716) 862-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mount St. Mary's Hospital of Niagara Falls CurrentSince Oct 30, 2020 Accepting new patients
Sisters of Charity Hospital of Buffalo New York CurrentSince Nov 1, 2020 Accepting new patients
Kenmore Mercy Hospital CurrentSince Oct 30, 2020 Accepting new patients
Mercy Hospital of Buffalo CurrentSince Oct 30, 2020 Accepting new patients
Sisters of Charity Hospital of Buffalo New York CurrentSince Nov 1, 2020 Accepting new patients
Mercy Hospital of Buffalo CurrentSince Oct 30, 2020 Accepting new patients
Sisters of Charity Hospital of Buffalo, New York Current Accepting new patients
Kenmore Mercy Hospital CurrentSince Oct 30, 2020 Accepting new patients
Kenmore Mercy Hospital Current Accepting new patients
Sisters of Charity Hospital of Buffalo New York Current Accepting new patients
Cogent Medical Care PC Internal Medicine CurrentSince Apr 1, 2015 Accepting new patients

Locations

144 Genesee St
Fl 3
Buffalo, NY 14203
Phone (716) 601-3690

1500 Broadway St
Buffalo, NY 14212
Phone (716) 422-2002

2157 Main St
Buffalo, NY 14214
Phone (716) 862-1501

565 Abbott Rd
Buffalo, NY 14220
Phone (716) 826-7000

565 Abbott Rd
Rm 8632
Buffalo, NY 14220
Phone (607) 798-5671

2605 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 891-2315

908 Niagara Falls Blvd
Ste 208
North Tonawanda, NY 14120
Phone (716) 649-1613

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

5300 Military Rd
Stela Niagara, NY 14092
Phone (716) 297-4800

2950 Elmwood Ave
Tonawanda, NY 14217
Phone (716) 447-6100

Interoperability endpoints

  • Direct secure messaging: jjung20368@direct.chsbuffalo.org

Organizations & group practices 11

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 12

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": "1221091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436832000000",
    "number": "1104075308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 BROADWAY AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142121845",
            "telephone_number": "716-893-8550",
            "fax_number": "716-893-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 BROADWAY AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142121845",
            "telephone_number": "716-893-8550",
            "fax_number": "716-893-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "JIYEON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-11",
        "last_updated": "2015-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "276106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.