Individual provider Active NPI

Boyoung Jang, ANP-BC

  • Adult Health Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1437579398
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F306441 Issued in NY
Practice address
760 Broadway
Brooklyn, NY 11206
Phone
(718) 963-6165
NPI assigned
Apr 18, 2014
Last updated
Jul 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F306441 NY Primary

Addresses

Primary practice location

760 Broadway
Brooklyn, NY 11206

Mailing address

7714 Bay Pkwy Apt 6F
Brooklyn, NY 11214-1533
Phone (917) 886-3255

Other practice location 1

1400 Pelham Pkwy S
Building#6 Adult ED-Urgent Care
Bronx, NY 10461-1138
Phone (917) 886-3255

Other identifiers 1

IdentifierTypeStateIssuer
03916561MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address boyoung.jang@nychhc.org Health Information Exchange (HIE)

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
I20190125000211 NY Order and Referring Only - Nurse Practitioner 0143440172

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F306441NYMDAdult Health Nurse Practitioner

Networks

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

Interoperability endpoints

  • Direct secure messaging: bjang671524@nychhc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1437579398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7714 BAY PKWY APT 6F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112141533",
            "telephone_number": "917-886-3255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 BROADWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11206",
            "telephone_number": "718-963-6165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Pelham Pkwy S",
            "address_2": "Building#6 Adult ED-Urgent Care",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104611138",
            "country_code": "US",
            "telephone_number": "917-886-3255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JANG",
        "first_name": "BOYOUNG",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-18",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F306441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03916561",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "boyoung.jang@nychhc.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "760 Broadway",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112065383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.