Individual provider Active NPI

Justin Leung, MD

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1578839098
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
277714 Issued in NY
Practice address
462 1St Ave
New York, NY 10016-9196
Phone
(212) 562-4678
Fax
(212) 562-7660
NPI assigned
Mar 29, 2012
Last updated
Sep 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 277714 NY Primary
Psychiatry Physician 2084P0800X FL4950033 NY

Addresses

Primary practice location

462 1St Ave
New York, NY 10016-9196

Mailing address

462 1St Ave
New York, NY 10016-9196
Phone (212) 562-4678

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
I20221202001371 NY Practitioner - Psychiatry 4789991225 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Feb 1, 2023 Accepting new patients
Montefiore Medical Center Psychiatry CurrentSince Dec 16, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Dec 16, 2022 Accepting new patients
Project Renewal Inc CurrentSince Jul 15, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Feb 1, 2023 Accepting new patients
Project Renewal Inc CurrentSince Jul 15, 2022 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1425 Madison Ave
New York, NY 10029
Phone (212) 824-8150

200 Varick St
Fl 9
New York, NY 10014
Phone (212) 620-0340

225 E 45th St
New York, NY 10017
Phone (212) 661-8934

Networks

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

Interoperability endpoints

  • Direct secure messaging: jleung678389@nychhc.direct-ci.com

Organizations & group practices 7

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": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1578839098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169196",
            "telephone_number": "212-562-4678",
            "fax_number": "212-562-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169196",
            "telephone_number": "212-562-4678",
            "fax_number": "212-562-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUNG",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-29",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "277714",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "FL4950033",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.