Individual provider Active NPI

Hyungsik Yoon

  • Chiropractor
  • Germantown, MD
National Provider Identifier
1346554847
Registry record updated Aug 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S03547 Issued in MD
Practice address
20030 Century Blvd
Ste # 203
Germantown, MD 20874-1111
Phone
(240) 246-7786
Fax
(240) 246-7815
NPI assigned
Jul 27, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X S03547 MD Primary
Chiropractor 111N00000X 0104556592 VA

Addresses

Primary practice location

20030 Century Blvd
Ste # 203
Germantown, MD 20874-1111

Mailing address

20030 Century Blvd
Ste # 203
Germantown, MD 20874-1111
Phone (240) 246-7786

Other identifiers 3

IdentifierTypeStateIssuer
773591OtherMDOPTUM
S829OtherMDCAREFIRST
9629632OtherMDAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140731001348 DC Practitioner - Chiropractic 1355567132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Texas Tech University Health Science Center School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

20030 Century Blvd
Suite 203
Germantown, MD 20874-1196
Phone (240) 246-7786

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104556592VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Yoon Chiropractic, LLC Chiropractor CurrentSince Jul 14, 2014 Accepting new patients

Locations

20030 Century Blvd
Ste 203
Germantown, MD 20874
Phone (240) 246-7786

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.

NPI Registry JSON

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

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377129600000",
    "number": "1346554847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20030 CENTURY BLVD",
            "address_2": "STE # 203",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208741111",
            "telephone_number": "240-246-7786",
            "fax_number": "240-246-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20030 CENTURY BLVD",
            "address_2": "STE # 203",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208741111",
            "telephone_number": "240-246-7786",
            "fax_number": "240-246-7815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOON",
        "first_name": "HYUNGSIK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-27",
        "last_updated": "2013-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S03547",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556592",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTUM",
            "identifier": "773591",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "S829",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9629632",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.