Individual provider Active NPI

Jane Young Namkoong, PA

  • Physician Assistant
  • Flushing, NY
National Provider Identifier
1295270585
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
020455-1 Issued in NY
Practice address
4500 Parsons Blvd
Flushing, NY 11355-2205
Phone
(718) 670-5000
NPI assigned
Dec 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 020455-1 NY Primary

Addresses

Primary practice location

4500 Parsons Blvd
Flushing, NY 11355-2205

Mailing address

4500 Parsons Blvd
Flushing, NY 11355-2205
Phone (718) 670-5766

Other names 1

  • Ms. Jane Young Chong Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170124002923 NY Practitioner - Physician Assistant 1456633585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.68 of 100Reported as group
Quality
88.38
Promoting interoperability
78
Improvement activities
40
Cost
68.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
020455NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Flushing Hospital Medical Center CurrentSince Jan 1, 2017 Accepting new patients

Locations

4500 Parsons Blvd
Flushing, NY 11355
Phone (718) 670-5631

14601 45th Ave
Flushing, NY 11355
Phone (718) 670-5562

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": "1482364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1295270585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 PARSONS BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113552205",
            "telephone_number": "718-670-5766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 PARSONS BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113552205",
            "telephone_number": "718-670-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMKOONG",
        "first_name": "JANE",
        "middle_name": "YOUNG",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-22",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020455-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANE",
            "last_name": "CHONG",
            "middle_name": "YOUNG",
            "prefix": "MS.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.