Individual provider Active NPI

Minsung Jeong, MSN, APRN, FNP-BC

  • Family Nurse Practitioner
  • Fair Lawn, NJ
National Provider Identifier
1902636194
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ15158300 Issued in NJ
Practice address
22-02 Broadway Ste 301
Fair Lawn, NJ 07410-3016
Phone
(201) 414-5732
NPI assigned
Aug 3, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 707868 NY
Registered Nurse 163W00000X 26NR24535600 NJ
Family Nurse Practitioner 363LF0000X 354927 NY
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 26NJ15158300 NJ Primary

Addresses

Primary practice location

22-02 Broadway Ste 301
Fair Lawn, NJ 07410-3016

Mailing address

22-02 Broadway Ste 301
Fair Lawn, NJ 07410-3016

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250521000240 NJ Practitioner - Nurse Practitioner 0749708923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Partners of Englewood PCGroup PAC ID 1153572482, 94 clinicians

Practice addresses (Care Compare)

22 -02 Broadway
Suite 301
Fair Lawn, NJ 07410-3016
Phone (201) 414-5732

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NR24535600NJMDRegistered Nurse
707868NYMDRegistered Nurse
26NJ15158300NJMDFamily Nurse Practitioner
354927NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Partners of Englewood, PC Multi-Specialty CurrentSince Jun 15, 2025 Accepting new patients
Medical Associates of Englewood, PC Multi-Specialty PastSince Jan 1, 2020 Accepting new patients

Locations

350 Engle St
Englewood, NJ 07631
Phone (201) 871-6073

22-02 Broadway
Ste 301
Fair Lawn, NJ 07410
Phone (201) 414-5016

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

661 Main St
Ste 202
Paterson, NJ 07503
Phone (973) 321-9845

637 State Rt 23
Ste 300
Pompton Plains, NJ 07444

1225 McBride Ave
Ste 218
Woodland Park, NJ 07424
Phone (201) 414-5732

Interoperability endpoints

  • Direct secure messaging: minsung.jeong.p1@direct.mmc.nextgenshare.com

Organizations & group practices 2

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 1

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": "1722643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1902636194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22-02 BROADWAY STE 301",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22-02 BROADWAY STE 301",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103016",
            "telephone_number": "201-414-5732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEONG",
        "first_name": "MINSUNG",
        "credential": "MSN, APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-03",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "707868",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR24535600",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "354927",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ15158300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

Verify at the official NPI Registry.