Active NPI
Sung Kyu Henry Oh, M.D.
- Gynecology Physician
- Philadelphia, PA
National Provider Identifier
1093745549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- MD-032826L
- Practice address
- 1820 S Broad St
Philadelphia, PA 19145-2303 - Phone
- (215) 468-7722
- Fax
- (215) 468-7729
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | MD-032826L | PA | Primary |
Addresses
Primary practice location
1820 S Broad St
Philadelphia, PA 19145-2303
Mailing address
717 Hollow Rd
Radnor, PA 19087-2803
Phone (610) 688-9012
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2049009000 | Other | PA | KEYSTONE HP EAST PRACTICE |
| 6204959B | Other | PA | CIGNA PROVIDER # |
| 0615534 | Medicaid | PA | |
| 5523080 | Other | PA | AETNA PPO PROVIDER # |
| 2665885 | Other | PA | AETNA HMO PROVIDER # |
| 0052854000 | Other | PA | KEYSTONE HP EAST PROVIDER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD-032826L | PA | MD | Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093745549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "717 HOLLOW RD",
"city": "RADNOR",
"state": "PA",
"postal_code": "190872803",
"telephone_number": "610-688-9012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1820 S BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191452303",
"telephone_number": "215-468-7722",
"fax_number": "215-468-7729"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OH",
"first_name": "SUNG KYU",
"middle_name": "HENRY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "PA",
"license": "MD-032826L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE HP EAST PRACTICE",
"identifier": "2049009000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PROVIDER #",
"identifier": "6204959B",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0615534",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO PROVIDER #",
"identifier": "5523080",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO PROVIDER #",
"identifier": "2665885",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE HP EAST PROVIDER",
"identifier": "0052854000",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.