Individual provider Active NPI

Peggy Suejin Myung, M.D., PH.D.

  • Dermatopathology Physician
  • New Haven, CT
National Provider Identifier
1063677474
Registry record updated Apr 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
License
52769 Issued in CT
Practice address
15 York St
LMP 5031
New Haven, CT 06510-3221
Phone
(215) 668-7559
NPI assigned
Jul 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dermatology Physician 207N00000X 52769 CT
Dermatopathology Physician 207ND0900X 52769 CT Primary

Addresses

Primary practice location

15 York St
LMP 5031
New Haven, CT 06510-3221

Mailing address

360 State St
Apt 3103
New Haven, CT 06510-3601
Phone (215) 668-7559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20140710000425 CT Practitioner - Dermatology 4587889308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Perelman School of Med at the University of Pennsylvania, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

15 York St
New Haven, CT 06510-3221
Phone (203) 688-6445

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Dermatology CurrentSince Jul 1, 2014 Accepting new patients
Yale University CurrentSince Jul 1, 2014 Accepting new patients

Locations

15 York St
#5031
New Haven, CT 06510
Phone (203) 785-4094

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

15 York St
New Haven, CT 06510
Phone (203) 688-5303

Interoperability endpoints

  • Direct secure messaging: pmyung44356@direct.ynhh.org

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.

Hospital & facility affiliations 2

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": "1216857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398124800000",
    "number": "1063677474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 STATE ST",
            "address_2": "APT 3103",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103601",
            "telephone_number": "215-668-7559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 YORK ST",
            "address_2": "LMP 5031",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103221",
            "telephone_number": "215-668-7559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYUNG",
        "first_name": "PEGGY",
        "middle_name": "SUEJIN",
        "name_prefix": "Ms.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-24",
        "last_updated": "2014-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "52769",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CT",
            "license": "52769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.