Individual provider Active NPI

Sung Tae Byun, MD

  • Hematology & Oncology Physician
  • Largo, FL
National Provider Identifier
1194769810
Registry record updated Aug 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
ME72379 Issued in FL
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

Updated by the provider on Aug 3, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
261657200MedicaidFL
830003154OtherFLRAILROAD 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
ME72379FLMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC Hematology CurrentSince Oct 1, 2015 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.

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

Verify at the official NPI Registry.