Individual provider Active NPI

Jae Yong Yoo, MD

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1295811966
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A45421 Issued in CA
Practice address
966 S Western Ave
Ste 208
Los Angeles, CA 90006-1016
Phone
(323) 731-2001
Fax
(323) 731-1482
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A45421 CA Primary

Addresses

Primary practice location

966 S Western Ave
Ste 208
Los Angeles, CA 90006-1016

Mailing address

966 S Western Ave
Ste 208
Los Angeles, CA 90006-1016
Phone (323) 731-2001

Other identifiers 1

IdentifierTypeStateIssuer
00A45421MedicaidCA

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100224000356 CA Practitioner - Internal MedicinePractitioner - Nephrology 7911002779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

966 S Western Ave
Suite 106
Los Angeles, CA 90006-1017

966 S Western Ave
Suite 208
Los Angeles, CA 90006-1016

Hospital & facility affiliations

  • Cross Care, Inc Home health agency, Los Angeles, CA, CCN 059383
  • Ace Home Health, Inc. Home health agency, Los Angeles, CA, CCN 058082

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19461/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jaeyoo@drjaeyoo.ssdirect.aprima.com

Organizations & group practices 1

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 2

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295811966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 S WESTERN AVE",
            "address_2": "STE 208",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900061016",
            "telephone_number": "323-731-2001",
            "fax_number": "323-731-1482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "966 S WESTERN AVE",
            "address_2": "STE 208",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900061016",
            "telephone_number": "323-731-2001",
            "fax_number": "323-731-1482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOO",
        "first_name": "JAE",
        "middle_name": "YONG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A45421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A45421",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.