Active NPI
Sun Yoo, MD
- Family Medicine Physician
- Utica, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD61376660
- Practice address
- 120 Hobart St
Utica, NY 13501-4308 - Phone
- (315) 798-1149
- Fax
- (315) 734-3565
- NPI assigned
- May 5, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD214070 | OR | |
| Family Medicine Physician | 207Q00000X | MD61376660 | WA | Primary |
Addresses
Primary practice location
120 Hobart St
Utica, NY 13501-4308
Mailing address
7201 N Interstate Ave
Portland, OR 97217-5523
Phone (800) 813-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA, OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD214070 | OR | MD | Family Medicine Physician |
| MD61376660 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Family Medicine | Current | Accepting new patients |
| Kaiser Foundation Health Plan of the Northwest | Family Medicine | Current | Accepting new patients |
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients |
Locations
10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946
7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051
2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400
1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801
7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000
2211 E Mill Plain Blvd
Vancouver, WA 98661
Phone (360) 418-6001
Organizations & group practices 5
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.
-
- General Practice Physician
- Portland, OR
- NPI 1184786527
Family Medicine, WA
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Bend, OR
- NPI 1154270445
WA
-
- General Practice Physician
- Portland, OR
- NPI 1649722034
-
- General Practice Physician
- Portland, OR
- NPI 1871848457
Family Medicine
-
- Clinic/Center
- Hillsboro, OR
- NPI 1942718622
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693267200000",
"number": "1083235675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7201 N INTERSTATE AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972175523",
"telephone_number": "800-813-2000",
"fax_number": "855-524-5255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 HOBART ST",
"city": "UTICA",
"state": "NY",
"postal_code": "135014308",
"telephone_number": "315-798-1149",
"fax_number": "315-734-3565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOO",
"first_name": "SUN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-05-05",
"last_updated": "2023-08-29",
"certification_date": "2023-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD214070",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD61376660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Utica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.