Individual provider Active NPI

Edward Jung, MD

  • Radiation Oncology Physician
  • West Covina, CA
National Provider Identifier
1003011941
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
D0076271 Issued in MD
Practice address
1115 S Sunset Ave Ste 100
West Covina, CA 91790-3940
Phone
(626) 225-2111
Fax
(626) 631-0952
NPI assigned
Jun 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X D0076271 MD Primary

Addresses

Primary practice location

1115 S Sunset Ave Ste 100
West Covina, CA 91790-3940

Mailing address

10400 Southwest Hwy Lowr Level
Chicago Ridge, IL 60415-2394
Phone (708) 581-7308

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NV2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171213001239 CA Practitioner - Radiation Oncology 5597909366 Reassigns benefits to 1 organization
I20220311001684 NV Practitioner - Radiation Oncology 5597909366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emanate Health Medical Care FoundationGroup PAC ID 9830544980, 85 clinicians

Practice addresses (Care Compare)

1115 S Sunset Ave
West Covina, CA 91790-3940

Hospital & facility affiliations

  • Emanate Health Inter-Community Hospital Hospital, Covina, CA, CCN 050382

Merit-based Incentive Payment System (MIPS)

Final score
82.35 of 100Reported as group
Quality
52.92
Promoting interoperability
93
Improvement activities
40
Cost
70.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Emanate Health Medical Care Foundation CurrentSince Jun 3, 2024 Accepting new patients
Susan Reisinger, MD Prof. Corp. Radiation Oncology CurrentSince Feb 17, 2022 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Compassionate Cancer Care Radiation Diagnostics Group Inc Radiation Oncology Past Accepting new patients
Therapeutic Radiology Asso, P.a. Radiation Oncology PastSince Jul 24, 1995 Accepting new patients
Emanate Health Medical Group PastSince Aug 18, 2024 Accepting new patients

Locations

1041 W Badillo St
Ste 104
Covina, CA 91722
Phone (626) 732-4168

1115 S Sunset Ave
Ste 100
West Covina, CA 91790
Phone (626) 225-2111

1115 S Sunset Ave
Ste 200
West Covina, CA 91790
Phone (626) 732-8390

2270 Colonial Blvd
Fort Myers, FL 33907
Phone (239) 344-2391

52 N Pecos Rd
Henderson, NV 89074
Phone (702) 990-4761

3006 S Maryland Pkwy
Ste 100
Las Vegas, NV 89109
Phone (702) 735-0006

2851 N Tenaya Way
Ste 100
Las Vegas, NV 89128
Phone (702) 243-3340

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1003011941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10400 SOUTHWEST HWY LOWR LEVEL",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "604152394",
            "telephone_number": "708-581-7308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 S SUNSET AVE STE 100",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903940",
            "telephone_number": "626-225-2111",
            "fax_number": "626-631-0952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-20",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MD",
            "license": "D0076271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.