Individual provider Active NPI

Hyohyun Jang

  • Family Nurse Practitioner
  • Maplewood, NJ
National Provider Identifier
1487190633
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95031362 Issued in CA
Practice address
2010 Springfield Ave
#101
Maplewood, NJ 07040-3437
Phone
(973) 275-9500
NPI assigned
Jan 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00696800 NJ
Family Nurse Practitioner 363LF0000X 95031362 CA Primary

Addresses

Primary practice location

2010 Springfield Ave
#101
Maplewood, NJ 07040-3437

Mailing address

2010 Springfield Ave
#101
Maplewood, NJ 07040
Phone (973) 275-9500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240905004460 CA Practitioner - Nurse Practitioner 7911263611 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Enloe Medical Center CurrentSince Jul 30, 2024 Accepting new patients
Enloe Medical Center CurrentSince Jul 30, 2024 Accepting new patients
Lansing Cardiovascular Consultants PC CurrentSince Sep 1, 2019 Accepting new patients
Enloe Medical Center Current Accepting new patients

Locations

1390 E Lassen Ave
Chico, CA 95973
Phone (530) 332-6332

185 E 7th Ave
Chico, CA 95926
Phone (530) 332-4400

2380 Cedar St
Holt, MI 48842
Phone (517) 349-3303

3413 Woods Edge
Okemos, MI 48864
Phone (517) 349-3303

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

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": "1484179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1487190633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 SPRINGFIELD AVE",
            "address_2": "#101",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "07040",
            "telephone_number": "973-275-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 SPRINGFIELD AVE",
            "address_2": "#101",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403437",
            "telephone_number": "973-275-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANG",
        "first_name": "HYOHYUN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-12",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00696800",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95031362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, NJ

Sources for this page

Verify at the official NPI Registry.