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MOONJU BAE
NPI 1912484627
Nurse Practitioner - Family in Jackson Heights, NY

Active since July 25, 2018PECOS Enrolled
3750 72ND ST, JACKSON HEIGHTS, NY 11372(844) 692-4692 Get Directions Write a Review

NPPES record last updated: May 22, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 22, 2026, Jul 25, 2018 (2 updates tracked since 2018).

About Moonju Bae NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOONJU BAE (NPI 1912484627) is an individual family provider in Jackson Heights, New York, licensed in New York (F343116) and active in the NPI registry since July 2018. She is enrolled in Medicare PECOS and maintains a secondary practice location in Astoria.

NPPES Registry Identity

NPI1912484627
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMOONJU BAE
Location Address3750 72ND STJackson Heights, NY 11372-6143
Mailing Address2213 City PlEdgewater, NJ 07020-3155 · (718) 618-0401 · Fax (607) 306-4582
Phone(844) 692-4692
Sole ProprietorNo
Enumeration DateJuly 25, 2018
Last NPPES UpdateMay 22, 20262 updates tracked since enumeration
NPPES CertifiedMay 22, 2026
✔ NPI 1912484627 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · F343116
3750 72ND ST, Jackson Heights, NY 11372
Open in Google Maps ↗

Secondary Practice Location 1

Location 13-01 27th AveAstoria, NY 11102 · Phone (718) 907-1344 · Fax (718) 907-1348

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Moonju Bae is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11372 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$104.17 typical visit price
range $67.00 – $201.98
Typical copayment $26.04 (range $16.75 – $50.49)
Most-billed visit code 99203
Established Patient
$116.96 typical visit price
range $21.62 – $163.52
Typical copayment $29.24 (range $5.40 – $40.88)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 7

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
13 suppliers56 claims111 services$6.18 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
9 suppliers29 claims29 services$1.05 avg. paid by Medicare
Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers23 claims1,740 services$0.31 avg. paid by Medicare
Mycophenolic acid, oral, 180 mg J7518
Treatment-Treatment - Miscellaneous · category RX029N
1 supplier12 claims1,440 services$0.89 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier11 claims11 services$202.66 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
3 suppliers20 claims20 services$18.03 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NEW YORK CITY HEALTH AND HOSPITALS CORPORATION
Clinic/Center
3750 72ND ST
JACKSON HEIGHTS, NY 11372
Queens County (212) 238-7815
MS. DENISE LUCERO LCSW
Social Worker (Clinical)
3750 72ND ST
JACKSON HEIGHTS, NY 11372
Queens County (844) 692-4692
BRIANNA OLAMIJU
Dermatology
3750 72ND ST
JACKSON HEIGHTS, NY 11372
Queens County (844) 692-4692
AMRITA BOSE PHARMD
Pharmacist (Ambulatory Care)
3750 72ND ST
JACKSON HEIGHTS, NY 11372
Queens County (844) 692-4692

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Moonju Bae's NPI number?

The NPI number for Moonju Bae is 1912484627. It was assigned to this individual provider in the NPPES registry on July 25, 2018.

Where is Moonju Bae located?

Moonju Bae practices at 3750 72nd St, Jackson Heights, NY 11372. The listed phone number is (844) 692-4692.

What is Moonju Bae's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Moonju Bae enrolled in Medicare?

Yes. Moonju Bae is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Moonju Bae was last updated on May 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.