Individual provider Active NPI

SE Young Han, MD

  • Hematology & Oncology Physician
  • Springfield, NJ
National Provider Identifier
1154652949
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
25MA10805600 Issued in NJ
Practice address
385 Morris Ave
Springfield, NJ 07081-1151
Phone
(973) 379-2111
Fax
(973) 379-2807
NPI assigned
Jan 19, 2010
Last updated
Sep 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 25MA10805600 NJ Primary

Addresses

Primary practice location

385 Morris Ave
Springfield, NJ 07081-1151

Mailing address

465 South St Ste 200
Morristown, NJ 07960-6439
Phone (973) 971-7206

Other practice location 1

741 Northfield Ave Ste 203
West Orange, NJ 07052-1104
Phone (973) 379-2111

Other identifiers 2

IdentifierTypeStateIssuer
1154652949MedicaidMO
36123924MedicaidIL

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
I20200714000268 NJ Practitioner - Hematology/Oncology 5597899393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596

651 Willow Grove St
Hackettstown, NJ 07840-1799
Phone (908) 441-1161

97 W Pkwy
Pompton Plains, NJ 07444-1647
Phone (973) 931-5000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group CurrentSince Jul 10, 2020 Accepting new patients

Locations

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

465 South St
Ste 200
Morristown, NJ 07960
Phone (973) 971-7130

Organizations & group practices 1

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 5

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": "1263859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1154652949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 SOUTH ST STE 200",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079606439",
            "telephone_number": "973-971-7206",
            "fax_number": "973-898-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 MORRIS AVE",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070811151",
            "telephone_number": "973-379-2111",
            "fax_number": "973-379-2807"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "741 Northfield Ave Ste 203",
            "address_purpose": "LOCATION",
            "city": "West Orange",
            "state": "NJ",
            "postal_code": "070521104",
            "country_code": "US",
            "telephone_number": "973-379-2111",
            "fax_number": "973-379-2807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAN",
        "first_name": "SE YOUNG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-19",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NJ",
            "license": "25MA10805600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154652949",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36123924",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, NJ

Sources for this page

Verify at the official NPI Registry.