Individual provider Active NPI

Jihan Ryu

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1285167817
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
299402 Issued in NY
Practice address
253 South St
New York, NY 10002-7827
Phone
(646) 740-1055
NPI assigned
Apr 10, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 299402 NY Primary

Addresses

Primary practice location

253 South St
New York, NY 10002-7827

Mailing address

253 South St
New York, NY 10002-7827
Phone (646) 740-1055

Other practice location 1

10811 48th Ave
Corona, NY 11368-2955
Phone (718) 899-8918

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
I20210910002432 NY Practitioner - Psychiatry 7113263963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Geisel School of Medicine at Dartmouth, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hamilton Madison House IncGroup PAC ID 7113819301, 8 clinicians

Practice addresses (Care Compare)

10811 48TH Ave
Corona, NY 11368-2955
Phone (212) 899-8918

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
299402NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hamilton Madison House, Inc CurrentSince Jan 17, 2025 Accepting new patients
Clinical Psychassociates LLP PastSince Apr 9, 2023 Accepting new patients

Locations

253 South St
Fl 3
New York, NY 10002
Phone (212) 720-4540

253 South St
New York, NY 10002
Phone (212) 720-4540

Networks

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

Organizations & group practices 2

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": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1285167817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 SOUTH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100027827",
            "telephone_number": "646-740-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 SOUTH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100027827",
            "telephone_number": "646-740-1055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10811 48th Ave",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "NY",
            "postal_code": "113682955",
            "country_code": "US",
            "telephone_number": "718-899-8918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYU",
        "first_name": "JIHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-10",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "299402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.