Davis Sungwhan Moon, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

74207 Issued in GA

Practice address

4750 Waters Ave Ste 500
Savannah, GA 31404-6261

Phone

(912) 352-8346

Fax

(912) 355-5515

NPI assigned

Dec 15, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA, SC2 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

Specialty

Vascular Surgery

Education

Mercer University School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Savannah Vascular Institute, LLCGroup PAC ID 2769542075, 20 clinicians

Health Services of Central GeorgiaGroup PAC ID 9638076730, 300 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Savannah Health Services LLC Dba Memorial Health University Medical Center Hospital, Savannah, GA, CCN 110036
• St Joseph's Hospital - Savannah Hospital, Savannah, GA, CCN 110043
• Southeast Georgia Health System- Brunswick Campus Hospital, Brunswick, GA, CCN 110025
• Memorial Health Meadows Hospital Hospital, Vidalia, GA, CCN 110128

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lwest447120@carolinashealthcaresystem.direct-ci.com
• Direct secure messaging: davis.moon.p1@direct.savannahvascular.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: davis.moon.p2@direct.savannahvascular.nextgenshare.com

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.

• Health Services of Central Georgia, Inc

  dba Atrium Health Navicent Medical Group

  • Multi-Specialty Clinic/Center
  • Macon, GA
  • NPI 1184679482
  Medicare reassignment Care Compare group NPD
• Savannah Vascular Institute, LLC

  • Vascular Surgery Physician
  • Savannah, GA
  • NPI 1184873390

  SC

  Medicare reassignment Care Compare group NPD
• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464
  Medicare reassignment NPD

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

• Saint Joseph's Hospital, Inc.

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1063406684
  Care Compare affiliation
• Savannah Health Services, LLC

  dba Memorial Health University Medical Center

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1053824292
  Care Compare affiliation
• Southeast Georgia Health System, Inc.

  dba Southeast Georgia Health System - Brunswick Campus

  • General Acute Care Hospital
  • Brunswick, GA
  • NPI 1598784720
  Care Compare affiliation
• Vidalia Health Services, LLC

  • General Acute Care Hospital
  • Vidalia, GA
  • NPI 1790376564
  Care Compare affiliation

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

{
    "created_epoch": "1229299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1043455306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 WATERS AVE STE 500",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046261",
            "telephone_number": "912-352-8346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 WATERS AVE STE 500",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046261",
            "telephone_number": "912-352-8346",
            "fax_number": "912-355-5515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "613 Towne Park Dr W Ste 204",
            "address_purpose": "LOCATION",
            "city": "Rincon",
            "state": "GA",
            "postal_code": "313265183",
            "country_code": "US",
            "telephone_number": "912-826-6771",
            "fax_number": "912-295-5605",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 Richland Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036849",
            "country_code": "US",
            "telephone_number": "803-434-7100",
            "fax_number": "803-434-6889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOON",
        "first_name": "DAVIS",
        "middle_name": "SUNGWHAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-15",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "SC",
            "license": "84913",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "74207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003223457H",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003223457A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rodney L Moody, MD
• Ryan Brett Moody, M.D
• Moon River Counseling LLC
• Andrea Moon
• Charlene H. Moon, NP
• Jin Moon
• Aigner Moore, MD
• Amani Moore, RBT
• Amy Sherrell Webb Moore, PMHNP
• Cheryl Jeanine Moore, LPN

• Vascular Surgery Physician in Savannah, GA
• Providers in Savannah, GA by specialty
• Vascular Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.