Individual provider Active NPI

Christina Soon Heo, AGNP-C

  • Adult Health Nurse Practitioner
  • Lyndhurst, NJ
National Provider Identifier
1518569482
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ14961700 Issued in NJ
Practice address
125 Chubb Ave
Lyndhurst, NJ 07071-3504
Phone
(201) 559-7600
NPI assigned
Nov 14, 2020
Last updated
Jun 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 310075 NY
Adult Health Nurse Practitioner 363LA2200X 26NJ14961700 NJ Primary

Addresses

Primary practice location

125 Chubb Ave
Lyndhurst, NJ 07071-3504

Mailing address

125 Chubb Ave
Lyndhurst, NJ 07071-3504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20251203000224 NJ Practitioner - Nurse Practitioner 2466809025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

125 Chubb Ave
Suite 100
Lyndhurst, NJ 07071-3501

2758 Middle Country Rd
Lake Grove, NY 11755-2118

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ14961700NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Service Professionals of NJ LLC CurrentSince Sep 20, 2025 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

30 Montgomery St
Fl 15
Jersey City, NJ 07302
Phone (551) 247-1029

125 Chubb Ave
Lyndhurst, NJ 07071
Phone (201) 559-7600

125 Chubb Ave
Ste 100S
Lyndhurst, NJ 07071
Phone (201) 559-7600

Networks

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

Interoperability endpoints

  • Direct secure messaging: cheo1507605@nychhc.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1605312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1518569482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 CHUBB AVE",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "070713504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 CHUBB AVE",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "070713504",
            "telephone_number": "201-559-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEO",
        "first_name": "CHRISTINA",
        "middle_name": "SOON",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-14",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "310075",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ14961700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyndhurst, NJ

Sources for this page

Verify at the official NPI Registry.