Eun Ji Jang, MD

Primary specialty

Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X

License

LP04884 Issued in RI

Practice address

593 Eddy St
Providence, RI 02903-4923

Phone

(401) 444-8360

Fax

(401) 444-5650

NPI assigned

Jun 22, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ejang43928@direct.ctc.masshiway.net

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.

• Greater New Bedford Community Health Center, Inc.

  • Community Health Clinic/Center
  • New Bedford, MA
  • NPI 1982607537
  Medicare reassignment NPD
• Greater New Bedford Community Health Center, Inc.

  • Community Health Clinic/Center
  • Wareham, MA
  • NPI 1073993937
  NPD

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1962922641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "874 PURCHASE ST",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027406232",
            "telephone_number": "508-992-6553",
            "fax_number": "508-984-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-8360",
            "fax_number": "401-444-5650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANG",
        "first_name": "EUN JI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "1012964",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "RI",
            "license": "LP04884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jammat Housing and Community Development Corporation
• Sripraharsha Srujan Jampana Raju
• Lynn Beth Janaway, APRN,BC
• Denise Janczynski, CRNA
• Barbara Nadia Jandasek, PH.D.
• Agnieszka Ewa Janicka, MD
• Adam Janicki, M.D.
• Robert H Janigian Jr., MD
• Janine Galione, PHD, LLC
• Sumbal Ashraf Janjua, M.D.

• Pediatric Infectious Diseases Physician in Providence, RI
• Providers in Providence, RI by specialty
• Pediatric Infectious Diseases Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; 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.

Verify at the official NPI Registry.