Individual provider Active NPI

Jonathan Shih-Chen Kung, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Brooklyn, NY
National Provider Identifier
1184983215
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
339 Hicks St
Brooklyn, NY 11201-5509
Phone
(925) 286-1628
NPI assigned
May 9, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 305893 NY
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

339 Hicks St
Brooklyn, NY 11201-5509

Mailing address

Mt. Sinai Doctors Downtown
104 Delancey Street
New York, NY 10002-5509
Phone (925) 286-1628

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
I20201102002315 NY Practitioner - Gastroenterology 6305197245 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, shared by 32 NPIs, 2,809 clinicians

Practice addresses (Care Compare)

104 Delancey St
New York, NY 10002-3202
Phone (212) 655-2157

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
305893NYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Gastroenterology CurrentSince Apr 1, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Dec 1, 2020 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Dec 1, 2020 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

141 S Central Ave
Ste 102
Hartsdale, NY 10530
Phone (914) 428-0529

104 Delancey St
New York, NY 10002
Phone (212) 533-5090

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

55 E 34th St
New York, NY 10016
Phone (212) 252-6131

150 E 42nd St
Frnt D
New York, NY 10017

Networks

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

Organizations & group practices 4

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": "1336521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1184983215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MT. SINAI DOCTORS DOWNTOWN",
            "address_2": "104 DELANCEY STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100025509",
            "telephone_number": "925-286-1628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 HICKS ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015509",
            "telephone_number": "925-286-1628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNG",
        "first_name": "JONATHAN",
        "middle_name": "SHIH-CHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-09",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "305893",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.