Active NPI
Jungwon Moon
- Acupuncturist
- Fresh Meadows, NY
National Provider Identifier
1497401475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 25MZ00158500
- Practice address
- 19617 73Rd Ave FL 1
Fresh Meadows, NY 11366-1808 - Phone
- (917) 273-1300
- NPI assigned
- Feb 28, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 25MZ00158500 | NJ | Primary |
Addresses
Primary practice location
19617 73Rd Ave FL 1
Fresh Meadows, NY 11366-1808
Mailing address
19617 73Rd Ave FL 1
Fresh Meadows, NY 11366-1808
Phone (917) 273-1300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MZ00158500 | NJ | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787788800000",
"number": "1497401475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19617 73RD AVE FL 1",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113661808",
"telephone_number": "917-273-1300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19617 73RD AVE FL 1",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113661808",
"telephone_number": "917-273-1300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOON",
"first_name": "JUNGWON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-28",
"last_updated": "2026-08-27",
"certification_date": "2026-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Acupuncturist",
"state": "NJ",
"license": "25MZ00158500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresh Meadows, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.