Ji Soo Moon, AG-ACNP - Medicare Nurse Practitioner in Forest Hills, NY

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Ji Soo Moon, AG-ACNP is a medicare enrolled "Nurse Practitioner - Acute Care" in Forest Hills, New York. She went to University Of Massachusetts Medical School and graduated in 2020 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice North Shore-lij Medical Pc and her current practice location is 10201 66th Rd, Forest Hills, New York. You can reach out to her office (for appointments etc.) via phone at (718) 830-4000.

Ji Soo Moon is licensed to practice in New York (license number F432459-01) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1043804255.

Contact Information

Ji Soo Moon, AG-ACNP
10201 66th Rd,
Forest Hills, NY 11375-2029
(718) 830-4000
Not Available

Map and Direction




Provider's Profile

Full NameJi Soo Moon
GenderFemale
SpecialityNurse Practitioner
Experience6 Years
Location10201 66th Rd, Forest Hills, New York
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Ji Soo Moon attended and graduated from University Of Massachusetts Medical School in 2020
  NPI Data:
  • NPI Number: 1043804255
  • Provider Enumeration Date: 02/28/2021
  • Last Update Date: 07/13/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 4284034943
  • Enrollment ID: I20240220003841

Medical Identifiers

Medical identifiers for Ji Soo Moon such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1043804255NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LA2100XNurse Practitioner - Acute Care RN2324806 (Massachusetts)Secondary
363LA2100XNurse Practitioner - Acute Care F432459-01 (New York)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ji Soo Moon allows following entities to bill medicare on her behalf.
Entity NameNew York University
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1285826438
PECOS PAC ID: 1355232422
Enrollment ID: O20081202000185
Entity NameNew York University
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1285826438
PECOS PAC ID: 1355232422
Enrollment ID: O20090822000026
Entity NameNorth Shore-lij Medical PC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1053688572
PECOS PAC ID: 3375701568
Enrollment ID: O20120220000262
Entity NameJsm Wellness NP in Acute Care P.C.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1255137592
PECOS PAC ID: 8123593019
Enrollment ID: O20260408002324

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ji Soo Moon is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice 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

Reviews and Comments


Nurse Practitioner Nurses in Forest Hills, NY

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
May Jean Cheung,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 6911 Yellowstone Blvd, Forest Hills, NY 11375
Phone: 646-379-5556    
Diksha Madaan,
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 10201 66th Ave, Forest Hills, NY 11375
Phone: 516-234-8471    
Dr. Adebola Osewa, DNP, PMHNP, FNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 10201 66th Rd, Forest Hills, NY 11375
Phone: 718-830-4316    
Nina Goldrich, NP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 6735 112th St, Forest Hills, NY 11375
Phone: 718-263-0740    Fax: 718-263-9894
Kerrin M Nelson, NP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 10201 66th Rd, Forest Hills, NY 11375
Phone: 718-830-4000    
Ms. Shan Shan Chen, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 7120 110th St, Forest Hills, NY 11375
Phone: 872-231-3162    Fax: 702-977-1496

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.