| Ji Soo Moon, AG-ACNP | |
|
10201 66th Rd, Forest Hills, NY 11375-2029 | |
| (718) 830-4000 | |
| Not Available |
| Full Name | Ji Soo Moon |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 4 Years |
| Location | 10201 66th Rd, Forest Hills, New York |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043804255 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LA2100X | Nurse Practitioner - Acute Care | RN2324806 (Massachusetts) | Secondary |
| 363LA2100X | Nurse Practitioner - Acute Care | F432459-01 (New York) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Umass Memorial Medical Center/university Campus | Worcester, MA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Umass Memorial Medical Group Inc | 4284539891 | 1889 |
| Entity Name | Umass Memorial Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760445373 PECOS PAC ID: 4284539891 Enrollment ID: O20040113000267 |
| Mailing Address | Practice Location Address |
|---|---|
| Ji Soo Moon, AG-ACNP 55 Lake Ave N, Worcester, MA 01655-0002 Ph: (508) 334-1000 | Ji Soo Moon, AG-ACNP 10201 66th Rd, Forest Hills, NY 11375-2029 Ph: (718) 830-4000 |
Ms. Maxine L Brooks, CNM, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 11247 Queens Blvd, Suite 102, Forest Hills, NY 11375 Phone: 718-263-2986 Fax: 718-544-6475 | |
Arkadiy Abraham Murdakhayev, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 6625 103rd St Apt 6g, Forest Hills, NY 11375 Phone: 646-387-5808 | |
May Jean Cheung, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 6911 Yellowstone Blvd, Forest Hills, NY 11375 Phone: 646-379-5556 | |
Mrs. Omolara A Olaniyi, PHD, FNP, RN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 11156 76th Dr, Forest Hills, NY 11375 Phone: 347-356-4434 Fax: 718-544-0972 | |
Diksha Madaan, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 10201 66th Ave, Forest Hills, NY 11375 Phone: 516-234-8471 | |
Ms. Adebola Osewa, RN, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 10201 66th Rd, Forest Hills, NY 11375 Phone: 718-830-4316 | |
Ms. Donna L Kearns, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 10201 66th Rd, Forest Hills, NY 11375 Phone: 212-830-1815 Fax: 212-459-3086 |