Eunjae Sung, CRNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

95010489 Issued in CA

Practice address

1740 W Gardena Blvd
Gardena, CA 90247-4764

Phone

(164) 804-3637

NPI assigned

Dec 18, 2015

Last updated

Sep 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, CA2 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

Specialty

Nurse Practitioner

Education

Washington University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Luke Medical Arts IncGroup PAC ID 1658604574, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St. Luke Medical Arts Inc

  dba Dongjin Sung, M.D. Internal Medicine

  • Internal Medicine Physician
  • Gardena, CA
  • NPI 1982161113
  Medicare reassignment Care Compare group
• Adfinitas Health at Fauquier, LLC

  • Hospitalist Physician
  • Warrenton, VA
  • NPI 1225558109
  Medicare reassignment NPD
• Advanced Premier Physicians Ipa

  dba Sarang Rehabilitation Clinic

  • Multi-Specialty Clinic/Center
  • Buena Park, CA
  • NPI 1689130759
  NPD (past)

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

{
    "created_epoch": "1450396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1235594185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 W GARDENA BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902474764",
            "telephone_number": "716-480-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W GARDENA BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902474764",
            "telephone_number": "164-804-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNG",
        "first_name": "EUNJAE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-18",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0024174203",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R218810",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95010489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Simone Summers
• Naajidah Summerville
• Jeffrey Sun
• Sung E Shim M D Inc
• Dongjin Sung, M.D.
• Glenna Sunga
• Sunshine Community Resource Organization Center
• Superior Care Medical Cener
• Natalie Renea Sutterland
• Suzie M. Wong DDS, Inc

• Primary Care Nurse Practitioner in Gardena, CA
• Providers in Gardena, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.