Individual provider Active NPI

Soo Y. Jung, MD

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1104261809
Registry record updated May 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MT203822 Issued in PA
Practice address
3400 Spruce St
Philadelphia, PA 19104-4206
Phone
(215) 662-6305
NPI assigned
May 8, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MT203822 PA Primary

Addresses

Primary practice location

3400 Spruce St
Philadelphia, PA 19104-4206

Mailing address

3400 Spruce St
Philadelphia, PA 19104-4206
Phone (215) 662-6305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, MD2 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
I20170714000623 DE Practitioner - Emergency Medicine 7315236932 Reassigns benefits to 2 organizations
I20220707000115 MD Practitioner - Emergency Medicine 7315236932 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 838-3088

Hospital & facility affiliations

  • Christiana Hospital Hospital, Newark, DE, CCN 080001
  • Union Hospital of Cecil County Hospital, Elkton, MD, CCN 210032

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Emergency Physicians LLC Emergency Medicine CurrentSince Jan 1, 2024 Accepting new patients
Christiana Care Health Services, Inc Current Accepting new patients
Christiana Care Emergency Physicians LLC Emergency Medicine CurrentSince Jan 1, 2024 Accepting new patients
Christiana Care Health Services Inc CurrentSince Jul 23, 2019 Accepting new patients
Christiana Care Health Services Inc Emergency Medicine CurrentSince Jul 23, 2019 Accepting new patients

Locations

621 Middletown Odessa Rd
Middletown, DE 19709
Phone (302) 203-1300

4755 Ogletown Stanton Rd
Newark, DE 19718
Phone (302) 733-1700

501 W 14th St
Wilmington, DE 19801
Phone (302) 320-4411

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

Organizations & group practices 6

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": "1367971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367971200000",
    "number": "1104261809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-6305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-6305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "SOO",
        "middle_name": "Y.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-08",
        "last_updated": "2013-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT203822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.