Individual provider Active NPI

Jung Ju, CRNA

  • Certified Registered Nurse Anesthetist
  • York, PA
National Provider Identifier
1063856482
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R177879 Issued in MD
Practice address
1001 S George St
York, PA 17403-3676
Phone
(717) 851-2345
Fax
(717) 741-5336
NPI assigned
Apr 29, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R177879 MD Primary
Certified Registered Nurse Anesthetist 367500000X RN615012 PA

Addresses

Primary practice location

1001 S George St
York, PA 17403-3676

Mailing address

110 Pine Grove Commons
York, PA 17403-5151
Phone (717) 741-5257

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MD, DC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20130829000508 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789827361
I20190715003236 MD Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789827361 Reassigns benefits to 2 organizations
I20190715003291 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789827361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Company LLCGroup PAC ID 4587559026, 373 clinicians

Practice addresses (Care Compare)

400 W 7TH St
Frederick, MD 21701-4506
Phone (240) 566-3300

70 Sherry LN
Suite 101
Prince Frederick, MD 20678-3276
Phone (410) 889-2040

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
63.85 of 100Reported as group
Quality
57.47
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R177879MDMDCertified Registered Nurse Anesthetist
RN615012PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Company, LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 6, 2024 Accepting new patients
First Colonies Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 12, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

851 Trafalgar Ct
Ste 200E
Maitland, FL 32751
Phone (321) 422-7155

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

11116 Medical Campus Rd
Hagerstown, MD 21742
Phone (301) 766-7600

70 Sherry Ln
Ste 101
Prnc Frederck, MD 20678
Phone (410) 889-2040

11210 Old Georgetown Rd
#12202
Rockville, MD 20852
Phone (301) 881-7770

11210 Old Georgetown Rd
Rockville, MD 20852
Phone (301) 881-7770

7600 Carroll Ave
Takoma Park, MD 20912
Phone (301) 791-7600

8322 Bellona Ave
Ste 201
Towson, MD 21204
Phone (410) 337-2688

Organizations & group practices 3

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 1

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": "1367193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1063856482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 PINE GROVE COMMONS",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174035151",
            "telephone_number": "717-741-5257",
            "fax_number": "717-741-5336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S GEORGE ST",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174033676",
            "telephone_number": "717-851-2345",
            "fax_number": "717-741-5336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JU",
        "first_name": "JUNG",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-29",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R177879",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN615012",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.