Active NPI
Hyun Kyung Jung
- Physical Therapist
- Brooklyn, NY
National Provider Identifier
1245847953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 044104
- Practice address
- 84 Linden Blvd BSMT
Brooklyn, NY 11226-3301 - Phone
- (347) 252-6215
- NPI assigned
- Sep 26, 2020
- Reactivated
- Jan 22, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 044104 | NY | Primary |
Addresses
Primary practice location
84 Linden Blvd BSMT
Brooklyn, NY 11226-3301
Mailing address
4037 77TH St Apt 5a
Elmhurst, NY 11373-1104
Phone (619) 208-3955
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230510002837 | NY | Practitioner - Physical Therapist in Private Practice | 0749646123 | Practice locations: New York, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 044104 | NY | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611273600000",
"number": "1245847953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4037 77TH ST APT 5A",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113731104",
"telephone_number": "619-208-3955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "84 LINDEN BLVD BSMT",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112263301",
"telephone_number": "347-252-6215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUNG",
"first_name": "HYUN KYUNG",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-26",
"last_updated": "2021-01-22",
"certification_date": "2021-01-22",
"deactivation_date": "2020-09-26",
"reactivation_date": "2021-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "NY",
"license": "044104",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.