Individual provider Active NPI

Justine Ryu, M.D.

  • Hematology & Oncology Physician
  • Orange, CT
National Provider Identifier
1881058899
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
75447 Issued in CT
Practice address
240 Indian River Rd
Orange, CT 06477-3649
Phone
(203) 795-1664
NPI assigned
Apr 6, 2016
Last updated
Aug 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 267294 MA
Hematology & Oncology Physician 207RH0003X 75447 CT Primary

Addresses

Primary practice location

240 Indian River Rd
Orange, CT 06477-3649

Mailing address

333 Cedar St. Www205
New Haven, CT 06510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231013001830 CT Practitioner - Hematology/Oncology 3971898214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Boston University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

35 Park St
New Haven, CT 06519-1110
Phone (203) 785-4191

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Internal Medicine CurrentSince Sep 2, 2023 Accepting new patients
Yale University CurrentSince Sep 2, 2023 Accepting new patients
Boston University Medical Center Past Accepting new patients

Locations

35 Park St
New Haven, CT 06519
Phone (203) 200-2100

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

Interoperability endpoints

  • Direct secure messaging: jryu628332@direct.ynhh.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1881058899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CEDAR ST. WWW205",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 INDIAN RIVER RD",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064773649",
            "telephone_number": "203-795-1664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYU",
        "first_name": "JUSTINE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-06",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "267294",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CT",
            "license": "75447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CT

Sources for this page

Verify at the official NPI Registry.