Individual provider Active NPI

Mihae Grace Joo, MD

  • Internal Medicine Physician
  • Mesa, AZ
National Provider Identifier
1134182744
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD20030642 Issued in NM
Practice address
6644 E Baywood Ave
Apogee Medical Group
Mesa, AZ 85206-1747
Phone
(480) 321-4391
Fax
(480) 981-4624
NPI assigned
Apr 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD20030642 NM Primary

Addresses

Primary practice location

6644 E Baywood Ave
Apogee Medical Group
Mesa, AZ 85206-1747

Mailing address

PO Box 708850
Sandy, UT 84070-8850
Phone (800) 846-5314

Other identifiers 1

IdentifierTypeStateIssuer
63224861MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20071120000715 CA Practitioner - Internal Medicine 8022919208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Loma Linda University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ximed Hospitalists, Inc.Group PAC ID 7214939222, 35 clinicians

Practice addresses (Care Compare)

9888 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 457-4123

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
78309CAMDSocial Worker
MD20030642NMMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ximed Hospitalists, Inc. CurrentSince Oct 1, 2007 Accepting new patients
Scripps Health Current Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

9850 Genesee Ave
Ste 900
La Jolla, CA 92037
Phone (858) 452-1279

Interoperability endpoints

  • Direct secure messaging: mjoo28397@scrippshlth.medalliesdirect.net

Organizations & group practices 2

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 1

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": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134182744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 708850",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840708850",
            "telephone_number": "800-846-5314",
            "fax_number": "801-352-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6644 E BAYWOOD AVE",
            "address_2": "APOGEE MEDICAL GROUP",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061747",
            "telephone_number": "480-321-4391",
            "fax_number": "480-981-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOO",
        "first_name": "MIHAE",
        "middle_name": "GRACE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD20030642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "63224861",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.