Individual provider Active NPI

Ji Soo Han, MD

  • Obstetrics Physician
  • Edison, NJ
National Provider Identifier
1649436205
Registry record updated Feb 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
MA08435100 Issued in NJ
Practice address
2 Lincoln Hwy
Suite 311a
Edison, NJ 08820-3961
Phone
(732) 603-2122
Fax
(732) 603-3566
NPI assigned
Aug 4, 2008
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2 Lincoln Hwy
Suite 511
Edison, NJ 08820-3961

Hospital & facility affiliations

  • JFK University Medical Center Hospital, Edison, NJ, CCN 310108

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
I20090217000030 NJ Practitioner - Obstetrics/Gynecology 3678638111 Practice locations: Edison, NJ

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA08435100NJMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Margaret Hague Womens Health Institute Past Accepting new patients

NPPES NPI Registry

Updated by the provider on Feb 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X MA08435100 NJ Primary

Addresses

Primary practice location

2 Lincoln Hwy
Suite 311a
Edison, NJ 08820-3961

Mailing address

2 Lincoln Hwy
Suite 311a
Edison, NJ 08820-3961
Phone (732) 603-2122

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 20, 2013.

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361318400000",
    "number": "1649436205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 LINCOLN HWY",
            "address_2": "SUITE 311A",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203961",
            "telephone_number": "732-603-2122",
            "fax_number": "732-603-3566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 LINCOLN HWY",
            "address_2": "SUITE 311A",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203961",
            "telephone_number": "732-603-2122",
            "fax_number": "732-603-3566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "JI SOO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-04",
        "last_updated": "2013-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "NJ",
            "license": "MA08435100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

Verify at the official NPI Registry.