Individual provider Active NPI

Kyung H Yoo, NP

  • Primary Care Nurse Practitioner
  • Westminster, MD
National Provider Identifier
1154072908
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
R220320 Issued in MD
Practice address
10 Distillery Rd Ste 200
Westminster, MD 21157-5344
Phone
(410) 871-1478
NPI assigned
Jan 13, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X R220320 MD Primary

Addresses

Primary practice location

10 Distillery Rd Ste 200
Westminster, MD 21157-5344

Mailing address

10 Distillery Rd Ste 200
Westminster, MD 21157-5344
Phone (410) 871-1478

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20220820000146 MD Practitioner - Nurse Practitioner 6204219454 Reassigns benefits to 3 organizations
I20220822000181 DC Practitioner - Nurse Practitioner 6204219454

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Access Carroll, Inc.Group PAC ID 8921412891, 4 clinicians

Practice addresses (Care Compare)

10 Distillery Rd
Suite 200
Westminster, MD 21157-5344
Phone (410) 871-1478

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R220320MDMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Seton Medical Group, Inc CurrentSince Aug 23, 2023 Accepting new patients
Access Carroll, Inc. CurrentSince Oct 2, 2025 Accepting new patients
Chase Brexton Health Services, Inc. CurrentSince Oct 7, 2024 Accepting new patients
Chase Brexton Health Services, Inc. CurrentSince Oct 7, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Mercy Ijoma-Family Health Connections PastSince Jan 1, 2022 Accepting new patients

Locations

1111 N Charles St
Baltimore, MD 21201
Phone (410) 486-5991

900 S Caton Ave
Baltimore, MD 21229
Phone (410) 368-3120

2850 North Ridge Rd
Ste 103
Ellicott City, MD 21043
Phone (410) 465-8119

10 Distillery Rd
Ste 200
Westminster, MD 21157
Phone (410) 871-1478

6901 Security Blvd
Ste 200
Windsor Mill, MD 21244

Interoperability endpoints

  • Direct secure messaging: kyung.yoo.1@9462.direct.athenahealth.com

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": "1642032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1154072908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DISTILLERY RD STE 200",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575344",
            "telephone_number": "410-871-1478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 DISTILLERY RD STE 200",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575344",
            "telephone_number": "410-871-1478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOO",
        "first_name": "KYUNG",
        "middle_name": "H",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-13",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "R220320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, MD

Sources for this page

Verify at the official NPI Registry.