Individual provider Active NPI

Woosin Chung, NP

  • Adult Health Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1003066556
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
NP 17479 Issued in CA
Practice address
1515 N Vermont Ave FL 2
Los Angeles, CA 90027-5337
Phone
(213) 220-9190
NPI assigned
Sep 21, 2008
Last updated
Jan 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X NP 17479 CA Primary

Addresses

Primary practice location

1515 N Vermont Ave FL 2
Los Angeles, CA 90027-5337

Mailing address

1515 N Vermont Ave FL 2
Los Angeles, CA 90027-5337
Phone (213) 220-9190

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20130620000557 CA Practitioner - Nurse Practitioner 0345489407 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP 17479CAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Sep 2, 2019 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 2, 2019 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince May 5, 2013 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince May 5, 2013 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

1515 N Vermont Ave
Fl 2
Los Angeles, CA 90027
Phone (213) 220-9190

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

4760 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 783-0567

401 S Fair Oaks Ave
Pasadena, CA 91105
Phone (323) 720-1144

988 S Fair Oaks Ave
Pasadena, CA 91105
Phone (626) 582-7980

3565 Del Amo Blvd
Torrance, CA 90503

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1221955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1003066556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N VERMONT AVE FL 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275337",
            "telephone_number": "213-220-9190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 N VERMONT AVE FL 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275337",
            "telephone_number": "213-220-9190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "WOOSIN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-21",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "NP 17479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4760 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.