Active NPI
Jaesun Jung, NP
- Acute Care Nurse Practitioner
- West New York, NJ
National Provider Identifier
1881292704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- F431540-01
- Practice address
- 51 65TH St
West New York, NJ 07093-4103 - Phone
- (917) 355-6171
- NPI assigned
- Oct 13, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | F431540-01 | NY | Primary |
Addresses
Primary practice location
51 65TH St
West New York, NJ 07093-4103
Mailing address
51 65TH St
West New York, NJ 07093-4103
Phone (917) 355-6171
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F431540-01 | NY | MD | Acute Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602547200000",
"number": "1881292704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 65TH ST",
"city": "WEST NEW YORK",
"state": "NJ",
"postal_code": "070934103",
"telephone_number": "917-355-6171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 65TH ST",
"city": "WEST NEW YORK",
"state": "NJ",
"postal_code": "070934103",
"telephone_number": "917-355-6171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUNG",
"first_name": "JAESUN",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-13",
"last_updated": "2020-10-13",
"certification_date": "2020-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Acute Care",
"state": "NY",
"license": "F431540-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West New York, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.