Nynos P.C.

Primary specialty

Neuro-ophthalmology PhysicianTaxonomy code 207WX0109X

Legal business name

NYNOS P.C.

Practice address

15814 Northern Blvd
ML6
Flushing, NY 11358-1135

Phone

(919) 428-1621

NPI assigned

Jun 30, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Bokkwan Jun, MD, PHDNPI 1124256581

Title

Owner

Phone

(919) 428-1621

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• NYNOS (New York Neuro-Ophthalmology and Strabismus) P.C. Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bokkwan Jun, M.D.

  • Neuro-ophthalmology Physician
  • Flushing, NY
  • NPI 1124256581
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662940800000",
    "number": "1972235646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15814 NORTHERN BLVD",
            "address_2": "STE ML06",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11358",
            "telephone_number": "718-799-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15814 NORTHERN BLVD",
            "address_2": "ML6",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113581135",
            "telephone_number": "919-428-1621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYNOS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-30",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A",
        "authorized_official_last_name": "JUN",
        "authorized_official_first_name": "BOKKWAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-428-1621",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "207WX0109X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology, Neuro-ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05458860",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NYNOS (New York Neuro-Ophthalmology and Strabismus) P.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Neuro-ophthalmology Physician in Flushing, NY
• Providers in Flushing, NY by specialty
• Neuro-ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.