NPIMap

Individual provider Active NPI

Jong Moon Woo, MD

  • Anesthesiology Physician
  • Cincinnati, OH
National Provider Identifier
1184607293
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
35046295W Issued in OH
Practice address
3131 Queen City Ave
Ohio Valley Anesthesia LLC
Cincinnati, OH 45238
Phone
(859) 341-7246
Fax
(859) 341-7867
NPI assigned
Nov 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 35046295W OH Primary

Addresses

Primary practice location

3131 Queen City Ave
Ohio Valley Anesthesia LLC
Cincinnati, OH 45238

Mailing address

20 Medical Village Drive
#258
Edgewood, KY 41017
Phone (859) 341-7246

Other identifiers 4

IdentifierTypeStateIssuer
200413420OtherINDIANA MEDICAID
0499045MedicaidOH
000000257501OtherANTHEM BLUE SHIELD
64060478OtherKYMEDICAID

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

LicenseStateTypeSpecialty
35046295WOHMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Anesthesiologists, Inc. Anesthesiology Past Accepting new patients
Physicians Anesthesia Service Inc Anesthesiology Past Accepting new patients
Anesthesiology Medical Services PSC Anesthesiology Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1184607293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MEDICAL VILLAGE DRIVE",
            "address_2": "#258",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "41017",
            "telephone_number": "859-341-7246",
            "fax_number": "859-341-7867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 QUEEN CITY AVE",
            "address_2": "OHIO VALLEY ANESTHESIA LLC",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45238",
            "telephone_number": "859-341-7246",
            "fax_number": "859-341-7867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOO",
        "first_name": "JONG",
        "middle_name": "MOON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35046295W",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA MEDICAID",
            "identifier": "200413420",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0499045",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE SHIELD",
            "identifier": "000000257501",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "64060478",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.