Individual provider Active NPI

Angela Jung McCarthy, M.D.

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1205060605
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D74114 Issued in MD
Practice address
632 Broadway PH
New York, NY 10012-2614
Phone
(800) 731-4254
Fax
(808) 263-5016
NPI assigned
May 13, 2009
Last updated
Feb 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101251017 VA
Internal Medicine Physician 207R00000X MD039839 DC
Internal Medicine Physician 207R00000X D74114 MD Primary

Addresses

Primary practice location

632 Broadway PH
New York, NY 10012-2614

Mailing address

632 Broadway PH
New York, NY 10012-2614
Phone (800) 731-4254

Other names 1

  • Dr. Angela Marie Jung Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, CT, GA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20160628002908 HI Practitioner - Internal Medicine 8022264167 Reassigns benefits to 1 organization
I20241126001663 CT Practitioner - Internal Medicine 8022264167
I20241219001420 GA Practitioner - Internal Medicine 8022264167 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD039839DCMDInternal Medicine Physician
D74114MDMDInternal Medicine Physician
0101251017VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Galileo Medical Group Ga, P.C. Internal Medicine CurrentSince Aug 10, 2024 Accepting new patients
Castle Medical Center CurrentSince Oct 1, 2016 Accepting new patients
Castle Medical Center CurrentSince Oct 1, 2016 Accepting new patients
Glenn G. Marinelli MD PA Past Accepting new patients

Locations

4300 Paces Ferry Rd SE
Ste 500
Atlanta, GA 30339
Phone (404) 496-8960

30 Aulike St
Ste 501
Kailua, HI 96734
Phone (808) 263-5011

640 Ulukahiki St
Kailua, HI 96734
Phone (808) 261-3326

64 Bleecker St
New York, NY 10012
Phone (302) 313-1584

Networks

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1205060605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 BROADWAY PH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122614",
            "telephone_number": "800-731-4254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 BROADWAY PH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122614",
            "telephone_number": "800-731-4254",
            "fax_number": "808-263-5016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "ANGELA",
        "middle_name": "JUNG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-13",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101251017",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD039839",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D74114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "JUNG",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.