Individual provider Active NPI

Kimberly Lauren Johung, M.D. PH.D

  • Radiation Oncology Physician
  • New Haven, CT
National Provider Identifier
1255505178
Registry record updated Apr 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
051767 Issued in CT
Practice address
20 York St
New Haven, CT 06510-3220
Phone
(203) 200-2100
Fax
(203) 200-2180
NPI assigned
Apr 22, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 051767 CT Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

20 York St
New Haven, CT 06510-3220

Mailing address

PO Box 208040
Dept of Therapeutic Radiology - Yale School of Medicine
New Haven, CT 06520-8040
Phone (203) 200-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20130723001031 CT Practitioner - Radiation Oncology 8224279989 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Yale University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

20 York St
New Haven, CT 06510-3220
Phone (203) 785-4638

Hospital & facility affiliations

  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022
  • Bridgeport Hospital Hospital, Bridgeport, CT, CCN 070010

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
051767CTMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Jul 1, 2013 Accepting new patients
Yale University CurrentSince Jul 1, 2013 Accepting new patients

Locations

350 Seymour Ave
Derby, CT 06418
Phone (203) 732-1260

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

20 York St
North Haven, CT 06510
Phone (203) 688-2433

Interoperability endpoints

  • Direct secure messaging: kjohung3518@direct.ynhh.org

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365465600000",
    "number": "1255505178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208040",
            "address_2": "DEPT OF THERAPEUTIC RADIOLOGY - YALE SCHOOL OF MEDICINE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065208040",
            "telephone_number": "203-200-2100",
            "fax_number": "203-200-2180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-200-2100",
            "fax_number": "203-200-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHUNG",
        "first_name": "KIMBERLY",
        "middle_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "M.D. PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-22",
        "last_updated": "2013-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CT",
            "license": "051767",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.