Active NPI
Anthony Sungjin Youn, M.D.
- Plastic Surgery Physician
- Troy, MI
National Provider Identifier
1164573424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 4301071818
- Practice address
- 755 W Big Beaver Rd
Suite 1200
Troy, MI 48084-4900 - Phone
- (248) 273-7700
- Fax
- (248) 273-7701
- NPI assigned
- Jan 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 4301071818 | MI | Primary |
| Plastic Surgery Physician | 208200000X | A82940 | CA |
Addresses
Primary practice location
755 W Big Beaver Rd
Suite 1200
Troy, MI 48084-4900
Mailing address
755 W Big Beaver Rd
Suite 1200
Troy, MI 48084-4900
Phone (248) 273-7700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A82940 | CA | MD | Plastic Surgery Physician |
| 4301071818 | MI | MD | Plastic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256688000000",
"number": "1164573424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "755 W BIG BEAVER RD",
"address_2": "SUITE 1200",
"city": "TROY",
"state": "MI",
"postal_code": "480844900",
"telephone_number": "248-273-7700",
"fax_number": "248-273-7701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "755 W BIG BEAVER RD",
"address_2": "SUITE 1200",
"city": "TROY",
"state": "MI",
"postal_code": "480844900",
"telephone_number": "248-273-7700",
"fax_number": "248-273-7701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUN",
"first_name": "ANTHONY",
"middle_name": "SUNGJIN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-15",
"last_updated": "2009-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "MI",
"license": "4301071818",
"primary": true
},
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "CA",
"license": "A82940",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.