Individual provider Active NPI

Shang Hyeun Han

  • Registered Nurse
  • Flushing, NY
National Provider Identifier
1225579071
Registry record updated Mar 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
693059 Issued in NY
Practice address
4040 195TH St
2FL
Flushing, NY 11358-3024
Phone
(929) 256-9219
NPI assigned
Mar 13, 2017
Last updated
Mar 13, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 693059 NY Primary

Addresses

Primary practice location

4040 195TH St
2FL
Flushing, NY 11358-3024

Mailing address

4040 195TH St
2FL
Flushing, NY 11358-3024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
693059NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1489363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1225579071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 195TH ST",
            "address_2": "2FL",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113583024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 195TH ST",
            "address_2": "2FL",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113583024",
            "telephone_number": "929-256-9219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "SHANG HYEUN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-13",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "693059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.