Active NPI
Kathleen Jung, M.D.
- Psychiatry Physician
- Bronx, NY
National Provider Identifier
1548428774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 248707
- Practice address
- 3340 Bainbridge Ave
Bronx, NY 10467-2802 - Phone
- (718) 696-3027
- NPI assigned
- May 23, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 24807 | NY | |
| Psychiatry Physician | 2084P0800X | 248707 | NY | Primary |
Addresses
Primary practice location
3340 Bainbridge Ave
Bronx, NY 10467-2802
Mailing address
3340 Bainbridge Ave
Bronx, NY 10467-2802
Phone (917) 540-9375
Other practice location 1
330 W 58th St Ste 604
New York, NY 10019-1817
Phone (917) 540-9375
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 248707 | NY | MD | Psychiatry Physician |
| 24807 | NY | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montefiore Medical Center | Psychiatry | Current | Accepting new patients |
| Montefiore Medical Center | Current | Accepting new patients |
Locations
111 E 210th St
Bronx, NY 10467
3340 Bainbridge Ave
Bronx, NY 10467
Phone (718) 696-3011
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- kajung@montefioredirect.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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Bronx, NY
- NPI 1194183715
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685664000000",
"number": "1548428774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3340 BAINBRIDGE AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104672802",
"telephone_number": "917-540-9375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3340 BAINBRIDGE AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104672802",
"telephone_number": "718-696-3027"
}
],
"practiceLocations": [
{
"address_1": "330 W 58th St Ste 604",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100191817",
"country_code": "US",
"telephone_number": "917-540-9375",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JUNG",
"first_name": "KATHLEEN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-23",
"last_updated": "2023-06-02",
"certification_date": "2023-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "NY",
"license": "24807",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "248707",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.