Individual provider Active NPI

Elisabeth Hyunjung Jang, FNP

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1982372405
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
347684 Issued in NY
Practice address
1060 Amsterdam Ave
New York, NY 10025-1715
Phone
(917) 951-7428
NPI assigned
Aug 31, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 779575 NY
Family Nurse Practitioner 363LF0000X 347684 NY Primary

Addresses

Primary practice location

1060 Amsterdam Ave
New York, NY 10025-1715

Mailing address

305 W 150TH St Apt 701
New York, NY 10039-0017
Phone (917) 951-7428

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220105000301 NY Practitioner - Nurse Practitioner 8123419959 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chinatown True Care Medical PLLCGroup PAC ID 2163859760, 245 clinicians

Practice addresses (Care Compare)

168 Centre St
FL 2
New York, NY 10013-6501
Phone (646) 854-3622

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
779575NYMDRegistered Nurse
347684NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jin Family Medical PLLC CurrentSince Feb 24, 2022 Accepting new patients
Chinatown True Care Medical PLLC CurrentSince Feb 24, 2022 Accepting new patients
Medical Director Services PC CurrentSince Sep 28, 2021 Accepting new patients

Locations

50 Sheffield Ave
Brooklyn, NY 11207
Phone (718) 250-8789

1311 Virginia St
Far Rockaway, NY 11691
Phone (718) 327-2908

13107 40th Rd
Ste E17
Flushing, NY 11354
Phone (718) 353-7626

4235 Main St
Ste 3E
Flushing, NY 11355
Phone (718) 886-5068

13107 40th Rd
Ste E18
Flushing, NY 11354
Phone (718) 353-8050

168 Centre St
Fl 2
New York, NY 10013
Phone (212) 966-8286

1060 Amsterdam Ave
New York, NY 10025
Phone (212) 316-7700

Networks

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

Organizations & group practices 3

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": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1982372405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 W 150TH ST APT 701",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100390017",
            "telephone_number": "917-951-7428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251715",
            "telephone_number": "917-951-7428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANG",
        "first_name": "ELISABETH",
        "middle_name": "HYUNJUNG",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "779575",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "347684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.