Active NPI
Sung Tae Byun, MD
- Hematology & Oncology Physician
- Largo, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- ME72379
- Practice address
- 8787 Bryan Dairy Rd
Suite 210
Largo, FL 33777-1251 - Phone
- (727) 397-9641
- Fax
- (727) 393-4194
- NPI assigned
- Jun 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | ME72379 | FL | Primary |
| Medical Oncology Physician | 207RX0202X | ME72379 | FL | |
| Hematology (Internal Medicine) Physician | 207RH0000X | ME72379 | FL |
Addresses
Primary practice location
8787 Bryan Dairy Rd
Suite 210
Largo, FL 33777-1251
Mailing address
4371 Veronica S Shoemaker Blvd
Attn Credentialing
Fort Myers, FL 33916-2216
Phone (239) 274-8200
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 261657200 | Medicaid | FL | |
| 830003154 | Other | FL | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060731000132 | FL | Practitioner - Hematology/Oncology | 8729091202 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME72379 | FL | MD | Hematology & Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Cancer Specialists & Research Institute, LLC | Hematology | Current | Accepting new patients |
Locations
4371 Veronica S Shoemaker Blvd
Fort Myers, FL 33916
Phone (239) 432-8500
100 Highland Ave N
Fl Cancer
Largo, FL 33770
Phone (727) 683-2900
8787 Bryan Dairy Rd
Ste 210
Largo, FL 33777
Phone (727) 394-1911
1970 Golf St
Fl Cancer
Sarasota, FL 34236
Phone (941) 795-3780
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.
-
- Medical Oncology Physician
- Cape Coral, FL
- NPI 1760590962
FL, Hematology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438560000000",
"number": "1194769810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4371 VERONICA S SHOEMAKER BLVD",
"address_2": "ATTN CREDENTIALING",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339162216",
"telephone_number": "239-274-8200",
"fax_number": "239-278-3350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8787 BRYAN DAIRY RD",
"address_2": "SUITE 210",
"city": "LARGO",
"state": "FL",
"postal_code": "337771251",
"telephone_number": "727-397-9641",
"fax_number": "727-393-4194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BYUN",
"first_name": "SUNG",
"middle_name": "TAE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-15",
"last_updated": "2015-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "FL",
"license": "ME72379",
"primary": true
},
{
"code": "207RX0202X",
"taxonomy_group": "",
"desc": "Internal Medicine, Medical Oncology",
"state": "FL",
"license": "ME72379",
"primary": false
},
{
"code": "207RH0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology",
"state": "FL",
"license": "ME72379",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "261657200",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "830003154",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Largo, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.