Individual provider Active NPI

Nara Kyungsun Um, M.D.

  • Internal Medicine Physician
  • Ellicott City, MD
National Provider Identifier
1275502163
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0062640 Issued in MD
Practice address
4725 Dorsey Hall Dr Ste A402
Ellicott City, MD 21042-7926
Phone
(202) 710-6512
NPI assigned
Mar 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0062640 MD Primary
Internal Medicine Physician 207R00000X MD438670 PA
Clinical Informatics Physician 2083C0008X MD438670 PA
Clinical Informatics Physician 2083C0008X D0062640 MD

Addresses

Primary practice location

4725 Dorsey Hall Dr Ste A402
Ellicott City, MD 21042-7926

Mailing address

4725 Dorsey Hall Dr Ste A402
Ellicott City, MD 21042-7926
Phone (202) 710-6512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20150319000256 PA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6608808209

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0062640MDMDInternal Medicine Physician
MD438670PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hemorrhoid Relief Center of Virginia, Inc. Past Accepting new patients
Helixcare Medical Group, LLC Past Accepting new patients
Franklin Square Hospital Center, Inc. Past Accepting new patients
Center for Hemorrhoid Relief, LLC Past Accepting new patients

Organizations & group practices 4

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1275502163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4725 DORSEY HALL DR STE A402",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427926",
            "telephone_number": "202-710-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 DORSEY HALL DR STE A402",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427926",
            "telephone_number": "202-710-6512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UM",
        "first_name": "NARA",
        "middle_name": "KYUNGSUN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0062640",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD438670",
            "primary": false
        },
        {
            "code": "2083C0008X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Clinical Informatics",
            "state": "PA",
            "license": "MD438670",
            "primary": false
        },
        {
            "code": "2083C0008X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Clinical Informatics",
            "state": "MD",
            "license": "D0062640",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

Verify at the official NPI Registry.