Individual provider Active NPI

Edward Jung

  • Pediatrics Physician
  • Hackensack, NJ
National Provider Identifier
1518617547
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA12738400 Issued in NJ
Practice address
30 Prospect Ave
Hackensack, NJ 07601-1915
Phone
(515) 996-2000
NPI assigned
Mar 24, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 25MA12738400 NJ Primary

Addresses

Primary practice location

30 Prospect Ave
Hackensack, NJ 07601-1915

Mailing address

5 Drayton PL
Wayne, NJ 07470-4141

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250731001265 NJ Practitioner - Pediatric Medicine 7113435355 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA12738400NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jul 1, 2025 Accepting new patients
Hackensack Meridian Health Medical Group - Primary Care PC Pediatrics CurrentSince Aug 2, 2025 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC Pediatrics CurrentSince Jul 1, 2025 Accepting new patients
HMH Hospitals Corporation Past Accepting new patients
Meridian Medical Group - Specialty Care, PC Pediatrics Past Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

300 Perrine Rd
Ste 324
Old Bridge, NJ 08857
Phone (732) 753-9890

Interoperability endpoints

  • FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 5

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": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1518617547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 DRAYTON PL",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074704141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "515-996-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-24",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA12738400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.