Individual provider Active NPI

Jennifer Shum, MD

  • Neurology Physician
  • Flushing, NY
National Provider Identifier
1124361886
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
290379 Issued in NY
Practice address
5645 Main St
Flushing, NY 11355-5045
Phone
(718) 670-1512
NPI assigned
Apr 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Epilepsy Physician 2084E0001X 290379 NY
Neurology Physician 2084N0400X 290379 NY Primary

Addresses

Primary practice location

5645 Main St
Flushing, NY 11355-5045

Mailing address

2649 Strang Blvd Ste 304
Yorktown Heights, NY 10598-2938
Phone (646) 745-6369

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
Direct Messaging Address jes4028@direct.nyp.org Direct
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190620000109 NY Practitioner - Neurology 7214261510 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Stanford University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York Queens Medicine and Surgery, P.C.Group PAC ID 4082883673, 401 clinicians

Practice addresses (Care Compare)

5645 Main St
Flushing, NY 11355-5045
Phone (718) 670-2000

Hospital & facility affiliations

  • New York-Presbyterian/Queens Hospital, Flushing, NY, CCN 330055

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
290379NYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York Queens Medicine and Surgery, P.C. CurrentSince Aug 9, 2021 Accepting new patients
New York Queens Medicine and Surgery, P.C. CurrentSince Aug 9, 2021 Accepting new patients
New York University CurrentSince Jul 1, 2019 Accepting new patients
New York University CurrentSince Jul 1, 2019 Accepting new patients
Newyork-Presbyterian-Queens Past Accepting new patients

Locations

4402 Francis Lewis Blvd
Ste B
Bayside, NY 11361
Phone (718) 428-1216

5645 Main St
Flushing, NY 11355
Phone (718) 670-1435

16303 Horace Harding Expy
Fl 2
Fresh Meadows, NY 11365
Phone (718) 888-9121

223 E 34th St
New York, NY 10016
Phone (212) 263-8854

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

2649 Strang Blvd
Ste 304
Yorktown Heights, NY 10598
Phone (646) 745-6369

Networks

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

Interoperability endpoints

  • Direct secure messaging: jes4028@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1364774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1124361886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2649 STRANG BLVD STE 304",
            "city": "YORKTOWN HEIGHTS",
            "state": "NY",
            "postal_code": "105982938",
            "telephone_number": "646-745-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5645 MAIN ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555045",
            "telephone_number": "718-670-1512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUM",
        "first_name": "JENNIFER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-01",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084E0001X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": "NY",
            "license": "290379",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "290379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "5645 Main St",
            "city": "Flushing",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113555045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jes4028@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "5645 Main St",
            "city": "Flushing",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113555045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "5645 Main St",
            "city": "Flushing",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113555045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.