Individual provider Active NPI

Jane Namkung, MD

  • Plastic and Reconstructive Surgery Physician
  • Vancouver, WA
National Provider Identifier
1124218722
Registry record updated Jun 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
MD60849336 Issued in WA
Practice address
13712 NE 10TH Ave
Vancouver, WA 98685
Phone
(360) 823-0860
NPI assigned
Jul 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X MD60849336 WA Primary

Addresses

Primary practice location

13712 NE 10TH Ave
Vancouver, WA 98685

Mailing address

13712 NE 10TH Ave
Vancouver, WA 98685-2628
Phone (360) 823-0860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA2 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
I20150727001798 CA Practitioner - Plastic and Reconstructive Surgery 1658519806 Reassigns benefits to 2 organizations
I20180725002415 WA Practitioner - Plastic and Reconstructive Surgery 1658519806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
New York Medical College, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salmon Creek Plastic Surgery PCGroup PAC ID 7113021478, 3 clinicians

Practice addresses (Care Compare)

13712 NE 10TH Ave
Vancouver, WA 98685-2628
Phone (360) 823-0860

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60849336WAMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda Health System CurrentSince Mar 10, 2016 Accepting new patients
Alameda Health System CurrentSince Mar 10, 2016 Accepting new patients
Tri Valley Plastic Surgeryprofessional Medical Corpor Plastic and Reconstructive Surgery CurrentSince May 25, 2015 Accepting new patients
Salmon Creek Plastic Surgery PC Plastic and Reconstructive Surgery CurrentSince Jul 30, 2018 Accepting new patients
Salmon Creek Plastic Surgery PC Plastic and Reconstructive Surgery CurrentSince Jul 30, 2018 Accepting new patients

Locations

11820 Dublin Blvd
Dublin, CA 94568
Phone (925) 875-0700

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

13712 NE 10th Ave
Vancouver, WA 98685
Phone (360) 823-0860

Interoperability endpoints

  • Direct secure messaging: jnamkung@salmoncreek.emadirect.md

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.

NPI Registry JSON

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1124218722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13712 NE 10TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986852628",
            "telephone_number": "360-823-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13712 NE 10TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98685",
            "telephone_number": "360-823-0860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMKUNG",
        "first_name": "JANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "WA",
            "license": "MD60849336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.