Organization Active NPI

Jun NP in Adult Health P.C.

  • Adult Health Nurse Practitioner
  • Flushing, NY
National Provider Identifier
1750853636
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
Legal business name
JUN NP IN ADULT HEALTH P.C.
Practice address
3636 Main St RM 2SD
Flushing, NY 11354-6549
Phone
(718) 353-8424
NPI assigned
Dec 17, 2018
Last updated
Dec 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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

Authorized official

Name
Jun LuNPI 1306126107
Title
President
Phone
(718) 353-8424

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X Primary
Internal Medicine Physician 207R00000X

Addresses

Primary practice location

3636 Main St RM 2SD
Flushing, NY 11354-6549

Mailing address

3636 Main St RM 2SD
Flushing, NY 11354-6549
Phone (718) 353-8424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190327002560 NY Part B Supplier - Clinic/Group Practice 2163762220 Receives reassigned benefits from 1 practitioner
Practice locations: Flushing, NY

National Provider Directory

National Provider Directory

Locations

3636 Main St
Rm 2SD
Flushing, NY 11354
Phone (718) 353-8424

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545004800000",
    "number": "1750853636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 MAIN ST RM 2SD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546549",
            "telephone_number": "718-353-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 MAIN ST RM 2SD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546549",
            "telephone_number": "718-353-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUN NP IN ADULT HEALTH P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-17",
        "status": "A",
        "authorized_official_last_name": "LU",
        "authorized_official_first_name": "JUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-353-8424"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.