Individual provider Active NPI

Jae Ryu

  • Obstetrics & Gynecology Physician
  • Flushing, NY
National Provider Identifier
1942379052
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
217530 Issued in NY
Practice address
133-47 Sanford Avenue
Flushing, NY 11355
Phone
(718) 359-1507
NPI assigned
Nov 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 217530 NY Primary

Addresses

Primary practice location

133-47 Sanford Avenue
Flushing, NY 11355

Mailing address

80 Marcus Drive
Provider Enrollment
Melville, NY 11747
Phone (631) 391-7887

Other identifiers 1

IdentifierTypeStateIssuer
02289430MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20110214000774 NY Practitioner - Obstetrics/Gynecology 4880874429 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Albert Einstein College of Medicine of Yeshiva University, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TJH Medical Services PCGroup PAC ID 8527960533, 215 clinicians

Practice addresses (Care Compare)

120 46 Queens Blvd
Kew Gardens, NY 11415
Phone (718) 006-6708

13347 Sanford Ave
C1A
Flushing, NY 11355-5870
Phone (718) 888-0179

Merit-based Incentive Payment System (MIPS)

Final score
85.41 of 100Reported as group
Quality
64.77
Promoting interoperability
79
Improvement activities
40
Cost
70.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
217530NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TJH Medical Services, P.C. Obstetrics & Gynecology CurrentSince Aug 1, 2002 Accepting new patients
Flushing Hospital Medical Center CurrentSince Sep 1, 2012 Accepting new patients
Flushing Hospital & Medical Center CurrentSince Sep 1, 2012 Accepting new patients
TJH Medical Services, PC Past Accepting new patients
The Schulman and Schachne Institute for Nursing and Rehabilitation Inc. Past Accepting new patients

Locations

4500 Parsons Blvd
Flushing, NY 11355
Phone (718) 670-5631

14601 45th Ave
Flushing, NY 11355
Phone (718) 670-5562

13347 Sanford Ave
Ste C1A
Flushing, NY 11355
Phone (718) 888-0179

11940 Metropolitan Ave
Kew Gardens, NY 11415
Phone (718) 849-0839

80 Marcus Dr
Melville, NY 11747
Phone (631) 391-7889

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: jryu2769@direct.medisys.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942379052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 MARCUS DRIVE",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "11747",
            "telephone_number": "631-391-7887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133-47 SANFORD AVENUE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11355",
            "telephone_number": "718-359-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYU",
        "first_name": "JAE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "217530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02289430",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.