Individual provider Active NPI

Bryan Su-Hyun Jeun, MD

  • Neuroradiology Physician
  • Springfield, MO
National Provider Identifier
1063674216
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
2014015319 Issued in MO
Practice address
3801 S National Ave
Springfield, MO 65807-5210
Phone
(417) 269-4056
NPI assigned
Jun 30, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2014015319 MO
Diagnostic Radiology Physician 2085R0202X DR.0068937 CO
Neuroradiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085N0700X 2014015319 MO Primary

Addresses

Primary practice location

3801 S National Ave
Springfield, MO 65807-5210

Mailing address

PO Box 802843
Kansas City, MO 64180-2843
Phone (417) 875-3000

Other practice location 1

5162 S Hanover St
Englewood, CO 80111-6242
Phone (417) 875-3000

Other identifiers 2

IdentifierTypeStateIssuer
1063674216MedicaidMO
200015934MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, CO2 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
I20140624001116 MO Practitioner - Diagnostic Radiology 6103040654 Reassigns benefits to 1 organization
I20220928003252 CO Practitioner - Diagnostic Radiology 6103040654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lester E Cox Medical CentersGroup PAC ID 8628092897, 243 clinicians

Practice addresses (Care Compare)

1001 E Primrose
Ferrell Duncan Clinic
Springfield, MO 65807-5155
Phone (417) 875-3000

5162 S Hanover St
Ferrell Duncan Clinic
Englewood, CO 80111-6242
Phone (417) 875-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.25 of 100Reported as group
Quality
64.73
Promoting interoperability
100
Improvement activities
40
Cost
76.1

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0068937COMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers Multi-Specialty CurrentSince Apr 21, 2015 Accepting new patients

Locations

801 N Lincoln Ave
Monett, MO 65708
Phone (417) 236-2440

1001 E Primrose St
Springfield, MO 65807
Phone (417) 875-3434

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

1530 E Republic Rd
Springfield, MO 65804
Phone (417) 269-1362

Interoperability endpoints

  • Direct secure messaging: bryan.jeun@cernerdirect.coxhealth.com

Organizations & group practices 1

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 4

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": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1063674216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 802843",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641802843",
            "telephone_number": "417-875-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 S NATIONAL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075210",
            "telephone_number": "417-269-4056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5162 S Hanover St",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "CO",
            "postal_code": "801116242",
            "country_code": "US",
            "telephone_number": "417-875-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEUN",
        "first_name": "BRYAN",
        "middle_name": "SU-HYUN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2014015319",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "DR.0068937",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Neuroradiology",
            "state": "MO",
            "license": "2014015319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063674216",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200015934",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.