Individual provider Active NPI

Lena Tung Munter, PA

  • Medical Physician Assistant
  • Port Washington, NY
National Provider Identifier
1669891339
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
017489 Issued in NY
Practice address
67 Shore Rd
Port Washington, NY 11050-2257
Phone
(516) 253-2890
NPI assigned
Apr 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 017489 NY Primary

Addresses

Primary practice location

67 Shore Rd
Port Washington, NY 11050-2257

Mailing address

24 Rockland Dr
Jericho, NY 11753-1409
Phone (917) 607-0611

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
I20150202000526 NY Practitioner - Physician Assistant 1658696240 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Lij Urgent Care PCGroup PAC ID 6002131778, 389 clinicians

Practice addresses (Care Compare)

377 S Oyster Bay Rd
Plainview, NY 11803-3323
Phone (516) 537-9061

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
017489NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Jan 16, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2023 Accepting new patients
Fpa Hospital Based CurrentSince Sep 17, 2018 Accepting new patients

Locations

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

300 Community Dr
Plandome, NY 11030

Interoperability endpoints

  • Direct secure messaging: lena.tung@ghuc.eclinicaldirectplus.com

Organizations & group practices 9

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": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1669891339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 ROCKLAND DR",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117531409",
            "telephone_number": "917-607-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 SHORE RD",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110502257",
            "telephone_number": "516-253-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNTER",
        "first_name": "LENA",
        "middle_name": "TUNG",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-10",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "017489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Washington, NY

Sources for this page

Verify at the official NPI Registry.