Individual provider Active NPI

Sugkee Youn, M.D.

  • Nephrology Physician
  • Centreville, VA
National Provider Identifier
1053498766
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
0101235830 Issued in VA
Practice address
13880 Braddock Rd Ste 107
Centreville, VA 20121-2460
Phone
(703) 965-0180
Fax
(703) 266-9003
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 0101235830 VA Primary

Addresses

Primary practice location

13880 Braddock Rd Ste 107
Centreville, VA 20121-2460

Mailing address

13880 Braddock Rd Ste 107
Centreville, VA 20121-2460
Phone (703) 965-0180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20071019000459 DC Practitioner - Internal MedicinePractitioner - Nephrology 8628003134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13880 Braddock Rd
Suite 107
Centreville, VA 20121-2460
Phone (703) 965-0180

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centreville Internal Medicine CurrentSince Nov 15, 2006 Accepting new patients
Subbarayudu Koppera MD, Inc Nephrology Past Accepting new patients

Locations

13880 Braddock Rd
Ste 107
Centreville, VA 20121
Phone (703) 266-0788

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1053498766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13880 BRADDOCK RD STE 107",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212460",
            "telephone_number": "703-965-0180",
            "fax_number": "703-266-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13880 BRADDOCK RD STE 107",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212460",
            "telephone_number": "703-965-0180",
            "fax_number": "703-266-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUN",
        "first_name": "SUGKEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "VA",
            "license": "0101235830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, VA

Sources for this page

Verify at the official NPI Registry.