Individual provider Active NPI

Jiaxun Zou

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1659064194
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
352177 Issued in NY
Practice address
5604 7TH Ave Ste 1
Brooklyn, NY 11220-4660
Phone
(216) 688-5629
NPI assigned
May 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 862078 NY
Family Nurse Practitioner 363LF0000X 352177 NY Primary

Addresses

Primary practice location

5604 7TH Ave Ste 1
Brooklyn, NY 11220-4660

Mailing address

5604 7TH Ave Ste 1
Brooklyn, NY 11220-4660
Phone (917) 508-5888

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240307000348 NY Practitioner - Nurse Practitioner 0840635314 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
862078NYMDRegistered Nurse
352177NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Century Medical Dermatology PLLC CurrentSince Mar 20, 2025 Accepting new patients
Dr WW Dermatology PLLC CurrentSince Jun 14, 2025 Accepting new patients
W&W Millennium Dermatology P.C. PastSince Sep 12, 2007 Accepting new patients

Locations

5604 7th Ave
Ste 1
Brooklyn, NY 11220
Phone (718) 360-7666

8516 Queens Blvd
#1
Elmhurst, NY 11373
Phone (718) 457-0002

13621 Franklin Ave
Ste 3B
Flushing, NY 11355
Phone (718) 445-6000

139 Centre St
Ste 215
New York, NY 10013
Phone (212) 343-1257

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": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1659064194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5604 7TH AVE STE 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112204660",
            "telephone_number": "917-508-5888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5604 7TH AVE STE 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112204660",
            "telephone_number": "216-688-5629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOU",
        "first_name": "JIAXUN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-31",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "862078",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "352177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.