Individual provider Active NPI

Samuel C Yoon, MD

  • Cardiovascular Disease Physician
  • Glen Burnie, MD
National Provider Identifier
1124010244
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
D58568 Issued in MD
Practice address
1417 Madison Park Dr
Glen Burnie, MD 21061-5613
Phone
(410) 768-6600
Fax
(410) 768-3132
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X D58568 MD Primary

Addresses

Primary practice location

1417 Madison Park Dr
Glen Burnie, MD 21061-5613

Mailing address

1417 Madison Park Dr
Glen Burnie, MD 21061-5613
Phone (410) 768-6600

Other identifiers 2

IdentifierTypeStateIssuer
060068541OtherMDRAILROAD MEDICARE
295050200MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20101008000011 MD Practitioner - Cardiovascular Disease (Cardiology) 8426240466 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
57.03 of 100Reported as individual
Quality
0
Improvement activities
40
Cost
90.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D58568MDMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Heart Center of Northern Anne Arundel County PA Cardiovascular Disease CurrentSince Jul 15, 2002 Accepting new patients
Baltimore Washington Medical Center Inc. CurrentSince Aug 15, 2014 Accepting new patients
Baltimore Washington Medical Center Inc. CurrentSince Aug 15, 2014 Accepting new patients
Baltimore Washington Medical Center Inc. Current Accepting new patients
Harbor Hospital Past Accepting new patients
North Arundel Cardiology Services, LLC Cardiovascular Disease Past Accepting new patients

Locations

1417 Madison Park Dr
Glen Burnie, MD 21061
Phone (410) 768-6600

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

300 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4940

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.

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1124010244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 MADISON PARK DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615613",
            "telephone_number": "410-768-6600",
            "fax_number": "410-768-3132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 MADISON PARK DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615613",
            "telephone_number": "410-768-6600",
            "fax_number": "410-768-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOON",
        "first_name": "SAMUEL",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MD",
            "license": "D58568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060068541",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "295050200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.