Individual provider Active NPI

Jenny Pang-Woo, FNP

  • Family Nurse Practitioner
  • Flushing, NY
National Provider Identifier
1730435066
Registry record updated Jul 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F337322-1 Issued in NY
Practice address
13604 Northern Blvd Ste Cu3
Flushing, NY 11354-6515
Phone
(718) 886-8386
NPI assigned
Jul 24, 2012
Last updated
Jul 24, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2012

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 F337322-1 NY Primary

Addresses

Primary practice location

13604 Northern Blvd Ste Cu3
Flushing, NY 11354-6515

Mailing address

13604 Northern Blvd Ste Cu3
Flushing, NY 11354-6515
Phone (718) 886-8386

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
I20160609000749 NY Order and Referring Only - Nurse Practitioner 9537459151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F337322-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thera Dynamic Physical Therapy P.C Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343088000000",
    "number": "1730435066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13604 NORTHERN BLVD STE CU3",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546515",
            "telephone_number": "718-886-8386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13604 NORTHERN BLVD STE CU3",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546515",
            "telephone_number": "718-886-8386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANG-WOO",
        "first_name": "JENNY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-24",
        "last_updated": "2012-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F337322-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.