Individual provider Active NPI

Lauren Jen, M.D.

  • Pediatrics Physician
  • Bronx, NY
National Provider Identifier
1538422845
Registry record updated Jul 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
283344 Issued in NY
Practice address
4350 Van Cortlandt Park E
Bronx, NY 10470-1875
Phone
(718) 231-6565
NPI assigned
Jun 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MT201624 PA
Pediatrics Physician 208000000X 283344 NY Primary

Addresses

Primary practice location

4350 Van Cortlandt Park E
Bronx, NY 10470-1875

Mailing address

4350 Van Cortlandt Park E
Bronx, NY 10470-1875
Phone (718) 231-6565

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160622000048 NY Practitioner - Pediatric Medicine 1658662697 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT201624PAMDPediatrics Physician

Practice roles (2 of 5)

OrganizationSpecialtyStatusNew patients
Boston Children'S Health Physicians, LLP Pediatrics CurrentSince Apr 9, 2016 Accepting new patients
Boston Childrens Health Physicians LLP CurrentSince Apr 9, 2016 Accepting new patients

Locations

4350 Van Cortlandt Park E
Bronx, NY 10470
Phone (718) 231-6565

19 Bradhurst Ave
Hawthorne, NY 10532
Phone (914) 493-7235

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469664000000",
    "number": "1538422845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 VAN CORTLANDT PARK E",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104701875",
            "telephone_number": "718-231-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 VAN CORTLANDT PARK E",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104701875",
            "telephone_number": "718-231-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEN",
        "first_name": "LAUREN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-21",
        "last_updated": "2016-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT201624",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "283344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.