Eun Ae Sung

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN002245 Issued in NV

Practice address

9811 W Charleston Blvd # 2-441
Las Vegas, NV 89117-7528

Phone

(702) 420-7704

NPI assigned

Jun 6, 2017

Sex

Female

Sole proprietor

No

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 NV

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shahab Mokhtare IncGroup PAC ID 3274857065, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eun.ae.sung.1@24737.direct.athenahealth.com

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.

• Shahab Mokhtare Inc

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1639576820
  Medicare reassignment Care Compare group NPD
• Shining Light LLC

  • Community Based Hospice Care Agency
  • Las Vegas, NV
  • NPI 1801481676
  NPD (past)

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496707200000",
    "number": "1366971194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9811 W CHARLESTON BLVD # 2-441",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891177528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9811 W CHARLESTON BLVD # 2-441",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891177528",
            "telephone_number": "702-420-7704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNG",
        "first_name": "EUN AE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-06",
        "last_updated": "2017-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN002245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heraganahally Nagegowda Sundar Raj, MD
• Sunday Eve Elderly Care LLC
• Kristy Marie Sundell
• Richard Michael Sundstrom
• Hyeran Sung Yoon, RPH
• Francis Sung, PHARMD
• Julia Sung, PA-C
• Glenn Arevalo Sunga
• Toni Anne Bonifacio Sunga
• Amy Sunkamaitis

• Family Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2017; 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.
• 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.