Individual provider Active NPI

Sungjoon Carlson, PA-C

  • Physician Assistant
  • Scottsdale, AZ
National Provider Identifier
1114474970
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10738 Issued in AZ
Practice address
13400 E Shea Blvd
Scottsdale, AZ 85259-5499
Phone
(480) 301-8000
NPI assigned
Sep 8, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10738 AZ Primary
Physician Assistant 363A00000X PA55487 CA
Physician Assistant 363A00000X 10002114A IN
Physician Assistant 363A00000X PA1834 NV

Addresses

Primary practice location

13400 E Shea Blvd
Scottsdale, AZ 85259-5499

Mailing address

13400 E Shea Blvd
Scottsdale, AZ 85259-5499
Phone (480) 301-8000

Other practice location 1

400 Parnassus Ave Fl 5
San Francisco, CA 94143-2202
Phone (415) 353-1616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA, AZ3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20170407001015 NV Practitioner - Physician Assistant 2365739091 Reassigns benefits to 5 organizations
I20220325001316 CA Practitioner - Physician Assistant 2365739091 Reassigns benefits to 6 organizations
I20241210003347 AZ Practitioner - Physician Assistant 2365739091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.47 of 100Reported as group
Quality
78.27
Promoting interoperability
100
Improvement activities
40
Cost
76.62

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10738AZMDClinical Social Worker
PA55487CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince Mar 18, 2022 Accepting new patients
Mayo Clinic Arizona CurrentSince Nov 28, 2024 Accepting new patients
Simonmed Reno PLLC CurrentSince Apr 1, 2024 Accepting new patients
Saint Marys Medical Group Inc. Current Accepting new patients
Mayo Clinic Arizona CurrentSince Nov 28, 2024 Accepting new patients
UCSF Medical Group Business Services CurrentSince Mar 18, 2022 Accepting new patients
Regents of the Univ of Ca CurrentSince Jul 15, 2024 Accepting new patients
University of California San Francisco CurrentSince Mar 18, 2022 Accepting new patients
Regents of the Univ of Ca CurrentSince Jul 15, 2024 Accepting new patients

Locations

5777 E Mayo Blvd
Phoenix, AZ 85054
Phone (480) 342-1800

13400 E Shea Blvd
Scottsdale, AZ 85259

16220 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254

1801 W Olympic Blvd
#1461
Pasadena, CA 91199

10850 White Rock Rd
Rancho Cordova, CA 95670

2221 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-2680

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
Fl 5
San Francisco, CA 94143
Phone (415) 353-2626

590 Eureka Ave
Reno, NV 89512
Phone (775) 323-5083

18653 Wedge Pkwy
Ste 300
Reno, NV 89511
Phone (775) 770-7210

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 18

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.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1114474970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595499",
            "telephone_number": "480-301-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595499",
            "telephone_number": "480-301-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Parnassus Ave Fl 5",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941432202",
            "country_code": "US",
            "telephone_number": "415-353-1616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "SUNGJOON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-08",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10738",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA55487",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002114A",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1834",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.