Individual provider Active NPI

Flavia Fernandes Jung, M.D

  • Pediatrics Physician
  • Watertown, NY
National Provider Identifier
1770699696
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
212699 Issued in NY
Practice address
238 Arsenal St
Watertown, NY 13601-2504
Phone
(315) 782-9450
Fax
(315) 782-1330
NPI assigned
Aug 22, 2006
Last updated
Feb 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X 2000-01601 LA
Pediatrics Physician 208000000X 212699 NY Primary

Addresses

Primary practice location

238 Arsenal St
Watertown, NY 13601-2504

Mailing address

238 Arsenal St
Watertown, NY 13601-2504
Phone (315) 782-9450

Other names 1

  • Flavia Jung Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
212699NYMDPediatrics Physician
2000-01601LAMDPediatric Nephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Pediatrics Assoc PA CurrentSince Oct 16, 2017 Accepting new patients
University of Maryland Pediatric Associates, PA Pediatrics CurrentSince Oct 16, 2017 Accepting new patients
University of Maryland Pediatric Associates, PA Pediatrics Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

22 S Greene St
Fl 5
Baltimore, MD 21201
Phone (410) 328-5887

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

Interoperability endpoints

  • Direct secure messaging: fjung@hiemail.healtheconnections.org

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, 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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1770699696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 ARSENAL ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012504",
            "telephone_number": "315-782-9450",
            "fax_number": "315-782-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 ARSENAL ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012504",
            "telephone_number": "315-782-9450",
            "fax_number": "315-782-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDES JUNG",
        "first_name": "FLAVIA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "LA",
            "license": "2000-01601",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "212699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FLAVIA",
            "last_name": "JUNG",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.