Individual provider Active NPI

Jungsik Seo

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1134518285
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95001214 Issued in CA
Practice address
845 S Manhattan PL #305
Los Angeles, CA 90005-3375
Phone
(310) 279-8106
NPI assigned
Jan 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95001214 CA Primary

Addresses

Primary practice location

845 S Manhattan PL #305
Los Angeles, CA 90005-3375

Mailing address

845 S Manhattan PL Apt 305
Los Angeles, CA 90005-3375
Phone (310) 279-8106

Other identifiers 1

IdentifierTypeStateIssuer
NP9001214MedicaidCA

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180611000204 CA Practitioner - Nurse Practitioner 1658626999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
UCLA Radiology Medical GroupGroup PAC ID 8921902065, 193 clinicians

Practice addresses (Care Compare)

100 Medical Plaza
Los Angeles, CA 90095-0001
Phone (310) 301-6800

1250 16TH St
Santa Monica, CA 90404-1249
Phone (424) 259-6000

200 Medical Plaza
Los Angeles, CA 90095-0001
Phone (310) 301-6800

300 Medical Plaza
Los Angeles, CA 90095-0001
Phone (310) 301-6800

300 UCLA Medical PLZ
Suite B130
Los Angeles, CA 90095-8346
Phone (310) 206-0456

757 Westwood PLZ
Los Angeles, CA 90095-8358
Phone (310) 825-9111

Hospital & facility affiliations

  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262
  • Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112

Merit-based Incentive Payment System (MIPS)

Final score
81.13 of 100Reported as group
Quality
62.91
Promoting interoperability
100
Improvement activities
40
Cost
68.15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
UCLA Radiology Medical Group CurrentSince Apr 23, 2018 Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
UCLA Medical Group Past Accepting new patients

Locations

300 Medical Plz
Ste B100
Los Angeles, CA 90095
Phone (310) 267-6675

757 Westwood Plz
Ste 2146
Los Angeles, CA 90095
Phone (310) 267-9793

300 UCLA Medical Plz
Ste B130
Los Angeles, CA 90095
Phone (310) 206-0456

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

757 Wt Blvd
Ste 2146
Los Angeles, CA 90095

1250 16th St
Santa Monica, CA 90404
Phone (310) 301-8695

100 Moody Ct
Thousand Oaks, CA 91360
Phone (805) 418-3500

Interoperability endpoints

  • Direct secure messaging: jseo11890@direct.uclahealth.org

Organizations & group practices 3

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": "1421107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1134518285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 S MANHATTAN PL APT 305",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900053375",
            "telephone_number": "310-279-8106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 S MANHATTAN PL #305",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900053375",
            "telephone_number": "310-279-8106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEO",
        "first_name": "JUNGSIK",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-13",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95001214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP9001214",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.