Stacey Jung

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

505 S Virgil Ave Ste 205
Los Angeles, CA 90020-1443

Phone

(213) 805-5822

NPI assigned

Apr 12, 2022

Last updated

Jul 25, 2022By 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 CA

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 1

Specialty

Physician Assistant

Education

University of Southern California Keck School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Han Orthopaedics IncGroup PAC ID 1153647433, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Han Orthopaedics Inc

  • Health Service Clinic/Center
  • Los Angeles, CA
  • NPI 1316348253
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1275275067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S VIRGIL AVE STE 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S VIRGIL AVE STE 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201443",
            "telephone_number": "213-805-5822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "STACEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-12",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Jung, OD
• Myung Sook Jung, AC
• Peter Byungchul Jung, O.D.
• Sharon Jung
• Sihun Jung
• Stephanie Jung
• Stephano Jung
• Susan H Jung, M.D.
• Thomas Jung
• Tiffany Jung, NP

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.