Flavia Fernandes Jung, M.D
Individual provider Active NPI Pediatrics Physician · Watertown, NY
NPI 1770699696 · NPPES record last updated Feb 14, 2020
Key facts
- NPI
- 1770699696
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 212699 (NY)
- Practice address
- 238 Arsenal St
Watertown, NY 13601-2504 - Phone
- (315) 782-9450
- Fax
- (315) 782-1330
- NPI assigned
- Aug 22, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 212699 | NY | MD | Pediatrics Physician |
| 2000-01601 | LA | MD | Pediatric Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Maryland Pediatric Associates, PA | Pediatrics | Current | Accepting new patients |
| University of Maryland Pediatrics Assoc PA | Current |
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
Fl 5
Baltimore, MD 21201
Phone (410) 328-5887
22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793
12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255
Interoperability endpoints
- fjung@hiemail.healtheconnections.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nephrology Physician | 2080P0210X | 2000-01601 | LA | |
| Pediatrics Physician | 208000000X | 212699 | NY | Yes |
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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4131550 | Medicaid | MD |
Other names
- Flavia Jung
Other providers in Watertown, NY
- Chelsea Felix
- Michelle D Felton
- Roxann Fennell
- Erica Tine-Rose Feola
- Emily C Ferguson
- Stefanie Ferrell
- Cassandra Fichthorn
- Kathleen A Finnerty
- India Fiocchi
- Andrea Fiorkey
All providers in Watertown, NY · Pediatrics Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.