Jenna Hyeonsoo Jung, MD

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

309501 Issued in NY

Practice address

1017 Jackson Ave
Long Island City, NY 11101-5986

Phone

(718) 971-9095

Fax

(718) 584-5869

NPI assigned

Mar 23, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Reenal Patel MD PC

  • Allergy & Immunology Physician
  • Long Island City, NY
  • NPI 1225669559
  Medicare reassignment NPD

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1508360439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 JACKSON AVE",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111015986",
            "telephone_number": "718-971-9095",
            "fax_number": "718-584-5869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 JACKSON AVE",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111015986",
            "telephone_number": "718-971-9095",
            "fax_number": "718-584-5869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "JENNA",
        "middle_name": "HYEONSOO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-23",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NY",
            "license": "309501",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "309501",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Jules
• Michael Juli, LCSW
• Kimberly Julien
• Connie Sehee Jung, OTR/L
• David Kun Ho Jung, DPT
• Jeremiah Edillor Juson, DMD
• Just a Moment Car Service Inc
• Jahanara Juthe
• Rita Kabashi, LMHC
• Kiki Kadianakis, D.O.

• Allergy & Immunology Physician in Long Island City, NY
• Providers in Long Island City, NY by specialty
• Allergy & Immunology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.