Active NPI
Seung Hea Han
- Physician Assistant
- San Jose, CA
National Provider Identifier
1043701170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA63222
- Practice address
- 5504 Monterey Highway
San Jose, CA 95138 - Phone
- (408) 729-9700
- Fax
- (510) 770-8141
- NPI assigned
- May 24, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 23038 | MD | |
| Physician Assistant | 363A00000X | PA63222 | CA | Primary |
Addresses
Primary practice location
5504 Monterey Highway
San Jose, CA 95138
Mailing address
5504 Monterey Highway
San Jose, CA 95138
Phone (408) 729-9700
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240108004065 | CA | Order and Referring Only - Physician Assistant | 4789035338 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23038 | MD | MD | Pharmacist |
| PA63222 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693872000000",
"number": "1043701170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5504 MONTEREY HIGHWAY",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "95138",
"telephone_number": "408-729-9700",
"fax_number": "510-770-8141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5504 MONTEREY HIGHWAY",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "95138",
"telephone_number": "408-729-9700",
"fax_number": "510-770-8141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAN",
"first_name": "SEUNG",
"middle_name": "HEA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-24",
"last_updated": "2023-09-05",
"certification_date": "2023-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "23038",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA63222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.