JSM Wellness NP in Acute Care P.C.

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

Legal business name

JSM WELLNESS NP IN ACUTE CARE P.C.

Practice address

215 Hallock Rd Ste 6a
Stony Brook, NY 11790-3077

Phone

(917) 563-1824

NPI assigned

Feb 19, 2025

Organization subpart

No

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

Authorized official

Name

Ji Soo Moon, DNPNPI 1043804255

Title

President

Phone

(917) 945-2497

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ji Soo Moon, AG-ACNP

  • Acute Care Nurse Practitioner
  • Forest Hills, NY
  • NPI 1043804255
  Medicare reassignment NPD Authorized official
• Mihee Song

  • Massage Therapist
  • Bethpage, NY
  • NPI 1164306072
  NPD

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

{
    "created_epoch": "1739923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1255137592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 HALLOCK RD STE 6A",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903077",
            "telephone_number": "917-563-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 HALLOCK RD STE 6A",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903077",
            "telephone_number": "917-563-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JSM WELLNESS NP IN ACUTE CARE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-19",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "JI SOO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-945-2497",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Wilson Joseph, DO
• Sara Joseph
• Isha Joshi, MD, MBA
• Karan Joshi, MD
• Kimberly Joyner, M.D.
• Hui Yu Juan, MD
• Joy Caroline Julius
• Kathy Lee Junior, PH.D
• Just Enjoy Life Acupuncturist and Nurse Practitioner in Adult Health (Just Enjoy Life Acupuncture And Wellness Center)
• Tracey A Juvet

• Acute Care Nurse Practitioner in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Acute Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.

Verify at the official NPI Registry.