Individual provider Active NPI

Jun Lu

  • Adult Health Nurse Practitioner
  • Flushing, NY
National Provider Identifier
1306126107
Registry record updated Oct 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F305764-1 Issued in NY
Practice address
3636 Main St # 2SD
Flushing, NY 11354-6549
Phone
(347) 345-7460
NPI assigned
Aug 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 547289-1 NY
Adult Health Nurse Practitioner 363LA2200X F305764-1 NY Primary

Addresses

Primary practice location

3636 Main St # 2SD
Flushing, NY 11354-6549

Mailing address

3636 Main St # 2SD
Flushing, NY 11354-6549
Phone (347) 345-9460

Other identifiers 2

IdentifierTypeStateIssuer
04835127MedicaidNY
G400430032OtherMEDICARE

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
I20170830001319 NY Practitioner - Nurse Practitioner 1557634383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3636 Main St
2SD
Flushing, NY 11354-6549

3808 Union St
Flushing, NY 11354-5543

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
547289-1NYMDPediatric Registered Nurse
F305764-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jun NP in Adult Health P.C. Adult Health CurrentSince Feb 10, 2019 Accepting new patients
Tien Physical Therapy PC PastSince Nov 3, 2019 Accepting new patients
Union Women Care OBGYN PLLC PastSince Mar 6, 2022 Accepting new patients

Locations

3636 Main St
Ste 2SD
Flushing, NY 11354
Phone (718) 200-5719

Networks

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

Organizations & group practices 3

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": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1306126107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 MAIN ST # 2SD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546549",
            "telephone_number": "347-345-9460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 MAIN ST # 2SD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546549",
            "telephone_number": "347-345-7460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LU",
        "first_name": "JUN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-24",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NY",
            "license": "547289-1",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F305764-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04835127",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "G400430032",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.