Jennifer K Jeong, AGACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

95012506 Issued in CA

Practice address

200 UCLA Medical PLZ Ste 550
Los Angeles, CA 90095-2328

Phone

(310) 206-6688

NPI assigned

Jul 17, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• The Regents of the University of California

  • Neurology Physician
  • Los Angeles, CA
  • NPI 1437117074
  Medicare reassignment NPD
• The Regents of the University of California

  • Land Ambulance
  • Los Angeles, CA
  • NPI 1962219410
  NPD
• UCLA Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1043427248
  NPD (past)

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

{
    "created_epoch": "1594944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1366050197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UCLA MEDICAL PLZ STE 550",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900952328",
            "telephone_number": "310-206-6688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3530 Wilshire Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900102328",
            "country_code": "US",
            "telephone_number": "866-983-3167",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1131 Wilshire Blvd Ste 302",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904012061",
            "country_code": "US",
            "telephone_number": "424-259-6559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEONG",
        "first_name": "JENNIFER",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "AGACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-17",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95012506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heesoo Jeong, M.D.
• Hong Seob Jeong
• Hyodong Jeong
• Jaeeun Jeong
• Janie Jeong
• Jessica Namyoung Jeong, OTD, OTR/L
• Jiyeon Monica Jeong
• Moonsun Jeong, NURSE PRACTITIONER
• Myeong Jeong
• Paul Jeong, DDS

• Acute Care Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Acute Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.