Individual provider Active NPI

Hyerim Jeon, NP

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1699326009
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F345095 Issued in NY
Practice address
1470 Madison Ave
New York, NY 10029-6542
Phone
(212) 824-8579
Fax
(212) 824-2330
NPI assigned
Sep 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F345095 NY Primary

Addresses

Primary practice location

1470 Madison Ave
New York, NY 10029-6542

Mailing address

1470 Madison Ave
New York, NY 10029-6542
Phone (332) 215-3002

Other practice location 1

2015 Grand Concourse
Bronx, NY 10453-4303
Phone (718) 299-7295

Other identifiers 1

IdentifierTypeStateIssuer
345095OtherNYNURSE PRACTITIONER IN FAMILY HEALTH LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200304002314 NY Practitioner - Nurse Practitioner 5890122790 Reassigns benefits to 2 organizations
I20260130000115 NJ Practitioner - Nurse Practitioner 5890122790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

5 E 98TH Street-1St FL
Dept of Neurology
New York, NY 10029-6501
Phone (212) 241-4572

Hospital & facility affiliations

  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F345095NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 13, 2020 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 13, 2020 Accepting new patients
Eterra Health PC CurrentSince Oct 1, 2025 Accepting new patients

Locations

158 Linwood Plz
Ste 307
Fort Lee, NJ 07024
Phone (201) 566-5396

5 E 98th St
Fl 1
New York, NY 10029
Phone (212) 241-5607

1470 Madison Ave
New York, NY 10029
Phone (212) 241-0806

Networks

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

Organizations & group practices 4

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 6

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589500800000",
    "number": "1699326009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1470 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296542",
            "telephone_number": "332-215-3002",
            "fax_number": "212-824-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296542",
            "telephone_number": "212-824-8579",
            "fax_number": "212-824-2330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2015 Grand Concourse",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104534303",
            "country_code": "US",
            "telephone_number": "718-299-7295",
            "fax_number": "718-299-6797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEON",
        "first_name": "HYERIM",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-26",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F345095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER IN FAMILY HEALTH LICENSE",
            "identifier": "345095",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.