Active NPI
Michelle Ji
- Emergency Medicine Physician
- Brooklyn, NY
National Provider Identifier
1619626439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- A208369
- Practice address
- 4802 10TH Ave
Brooklyn, NY 11219-2916 - Phone
- (718) 283-6000
- NPI assigned
- Mar 20, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | A208369 | CA | Primary |
Addresses
Primary practice location
4802 10TH Ave
Brooklyn, NY 11219-2916
Mailing address
2500 California PLZ
Omaha, NE 68178-1721
Phone (402) 280-2700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Creighton University School of Medicine, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
5000 Hopyard Rd
Suite 410
Pleasanton, CA 94588-3145
672 4TH Ave
Apt 2
Brooklyn, NY 11232-1264
672 4TH Ave
Apt 2
Brooklyn, NY 11232-1265
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782777600000",
"number": "1619626439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 CALIFORNIA PLZ",
"city": "OMAHA",
"state": "NE",
"postal_code": "681781721",
"telephone_number": "402-280-2700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4802 10TH AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112192916",
"telephone_number": "718-283-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JI",
"first_name": "MICHELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-03-20",
"last_updated": "2026-06-30",
"certification_date": "2026-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "A208369",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.