Active NPI
Kyungsuk Jung, MD MPH
- Hematology & Oncology Physician
- Springfield, IL
National Provider Identifier
1265792196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- 036134301
- Practice address
- 315 W Carpenter St
Clinic B
Springfield, IL 62702 - Phone
- (217) 545-8000
- Fax
- (217) 545-1141
- NPI assigned
- May 25, 2012
- 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 |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | MD452317 | PA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | IL | ||
| Hematology & Oncology Physician | 207RH0003X | 036134301 | IL | Primary |
Addresses
Primary practice location
315 W Carpenter St
Clinic B
Springfield, IL 62702
Mailing address
PO Box 19678
Springfield, IL 62794-9678
Phone (217) 545-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Hematology/Oncology
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1624 S I St
Suite 102
Tacoma, WA 98405-5029
Phone (253) 428-8700
Hospital & facility affiliations
- St Joseph Medical Center
- St Francis Community Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036134301 | IL | MD | Hematology & Oncology Physician |
| MD452317 | PA | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Medical Specialties PLLC | Current | Accepting new patients | |
| Northwest Medical Specialties Pharmacy | Past | Accepting new patients |
Locations
34509 9th Ave S
Ste 107
Federal Way, WA 98003
Phone (253) 272-7777
1624 S I St
Ste 405
Tacoma, WA 98405
Phone (253) 274-4545
1624 S I St
Ste 102
Tacoma, WA 98405
Phone (253) 383-3366
1624 S I St
Ste 305
Tacoma, WA 98405
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Tacoma, WA
- NPI 1548261308
-
- Clinic Pharmacy
- Tacoma, WA
- NPI 1053489062
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Tacoma, WA
- NPI 1124291117
-
- General Acute Care Hospital
- Tacoma, WA
- NPI 1952309098
-
- General Acute Care Hospital
- Federal Way, WA
- NPI 1093713091
-
- General Acute Care Hospital
- Federal Way, WA
- NPI 1922305606
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589241600000",
"number": "1265792196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19678",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627949678",
"telephone_number": "217-545-8000",
"fax_number": "217-545-1141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 W CARPENTER ST",
"address_2": "CLINIC B",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "62702",
"telephone_number": "217-545-8000",
"fax_number": "217-545-1141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUNG",
"first_name": "KYUNGSUK",
"credential": "MD MPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-25",
"last_updated": "2020-05-12",
"certification_date": "2020-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "PA",
"license": "MD452317",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "IL",
"license": null,
"primary": false
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "IL",
"license": "036134301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2020; 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.