Individual provider Active NPI

Simon Sinmin Chung, MD

  • Urology Physician
  • Fairfax, VA
National Provider Identifier
1386636579
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
0101044320 Issued in VA
Practice address
8081 Innovation Park Dr
Fairfax, VA 22031-4867
Phone
(571) 472-4724
Fax
(571) 472-0241
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 0101044320 VA Primary

Addresses

Primary practice location

8081 Innovation Park Dr
Fairfax, VA 22031-4867

Mailing address

8503 Arlington Blvd
#310
Fairfax, VA 22031-4628
Phone (703) 208-4200

Other practice location 1

8503 Arlington Blvd
#310
Fairfax, VA 22031-4628
Phone (703) 208-4200

Other identifiers 8

IdentifierTypeStateIssuer
010272891MedicaidVA
4312086OtherAETNA PPO
502647OtherNCPPO
1224156OtherAETNA HMO
540911708OtherMAMSI LIFE/ALLIANCE
188960OtherANTHEM PROSPERITY
192394OtherANTHEM FAIR OAKS
N1900014OtherCAREFIRST BCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address schung24962@soc.inova.org Health Information Exchange (HIE) Inova Health Care Services

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060324000343 DC Practitioner - Urology 0648215756 Reassigns benefits to 2 organizations
I20181003000185 VA Practitioner - Urology 0648215756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Hahneman Medical College of the Pacific, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

3300 Gallows Rd
Falls Church, VA 22042-3307

8081 Innovation Park Dr
Fairfax, VA 22031-4867

Hospital & facility affiliations

  • Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063
  • Inova Alexandria Hospital Hospital, Alexandria, VA, CCN 490040
  • Inova Fair Oaks Hospital Hospital, Fairfax, VA, CCN 490101
  • Inova Mount Vernon Hospital Hospital, Alexandria, VA, CCN 490122
  • Inova Loudoun Hospital Hospital, Leesburg, VA, CCN 490043

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101044320VAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Oct 6, 2014 Accepting new patients
Inova Health Care Services CurrentSince Jul 11, 2018 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

3299 Woodburn Rd
Ste 210
Annandale, VA 22003
Phone (703) 204-0000

8081 Innovation Park Dr
Ste 301
Fairfax, VA 22031
Phone (571) 472-6431

8503 Arlington Blvd
Ste 310
Fairfax, VA 22031
Phone (703) 208-4200

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

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.

Hospital & facility affiliations 7

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1386636579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8503 ARLINGTON BLVD",
            "address_2": "#310",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314628",
            "telephone_number": "703-208-4200",
            "fax_number": "703-876-1799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8081 INNOVATION PARK DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314867",
            "telephone_number": "571-472-4724",
            "fax_number": "571-472-0241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8503 Arlington Blvd",
            "address_2": "#310",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220314628",
            "country_code": "US",
            "telephone_number": "703-208-4200",
            "fax_number": "703-876-1799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "SIMON",
        "middle_name": "SINMIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0101044320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010272891",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4312086",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPPO",
            "identifier": "502647",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "1224156",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI LIFE/ALLIANCE",
            "identifier": "540911708",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROSPERITY",
            "identifier": "188960",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM FAIR OAKS",
            "identifier": "192394",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "N1900014",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "schung24962@soc.inova.org",
            "affiliation": "Y",
            "endpointDescription": "Health Information Exchange",
            "affiliationName": "Inova Health Care Services",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "8081 Innovation Park Dr",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220314867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.