Individual provider Active NPI

Su-Min Oon, MD

  • Addiction Medicine (Anesthesiology) Physician
  • Gainesville, FL
National Provider Identifier
1356339840
Registry record updated Jun 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Anesthesiology) PhysicianTaxonomy code 207LA0401X
License
ME76691 Issued in FL
Practice address
1131 NW 64TH Ter
Suite C
Gainesville, FL 32605-4218
Phone
(352) 331-5557
Fax
(352) 331-5510
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X ME76691 FL
Addiction Medicine (Anesthesiology) Physician 207LA0401X ME76691 FL Primary

Addresses

Primary practice location

1131 NW 64TH Ter
Suite C
Gainesville, FL 32605-4218

Mailing address

777 Hemlock St
Macon, GA 31201-2102
Phone (478) 633-5556

Other identifiers 3

IdentifierTypeStateIssuer
261327100MedicaidFL
276243OtherFLAVMED
51058OtherFLBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME76691FLMDAddiction Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Simedhealth LLC PastSince Dec 1, 2015 Accepting new patients
North Florida Pain Specialists PA Pain Medicine PastSince Nov 1, 2004 Accepting new patients
Tampa Pain Relief Center, Inc. Past Accepting new patients
Tri-County Anesthesia Volusia 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": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1356339840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 HEMLOCK ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012102",
            "telephone_number": "478-633-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 NW 64TH TER",
            "address_2": "SUITE C",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054218",
            "telephone_number": "352-331-5557",
            "fax_number": "352-331-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OON",
        "first_name": "SU-MIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "FL",
            "license": "ME76691",
            "primary": false
        },
        {
            "code": "207LA0401X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Addiction Medicine",
            "state": "FL",
            "license": "ME76691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261327100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "276243",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51058",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.