Individual provider Active NPI

Jai Jun Byeon, MD

  • Family Medicine Physician
  • Federal Way, WA
National Provider Identifier
1386694982
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00044106 Issued in WA
Practice address
31405 18TH Ave S
Federal Way, WA 98003-5433
Phone
(253) 681-6600
Fax
(253) 681-6645
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00044106 WA Primary

Addresses

Primary practice location

31405 18TH Ave S
Federal Way, WA 98003-5433

Mailing address

PO Box 34703
Seattle, WA 98124-1703
Phone (253) 681-6626

Other identifiers 2

IdentifierTypeStateIssuer
8453284MedicaidWA
P00393772OtherRAILROAD MEDICARE

Other names 1

  • Dr. Jai Jun Byeon Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20060531000239 WA Practitioner - Family Practice 3678584802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sea Mar Community Health CentersGroup PAC ID 7315831161, 235 clinicians

Practice addresses (Care Compare)

31405 18TH Ave S
Federal Way, WA 98003-5433
Phone (253) 681-6600

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Mar Community Health Centers CurrentSince Oct 5, 2014 Accepting new patients
Sea Mar Community Health Centers Family Medicine Current Accepting new patients
Sea Mar Community Health Centers Family Medicine CurrentSince Oct 5, 2014 Accepting new patients
Peninsula Community Health Services Family Medicine Past Accepting new patients
Sea-Mar Community Health Center Family Medicine Past Accepting new patients

Locations

1813 Sumner Ave
Aberdeen, WA 98520
Phone (360) 538-1293

3010 State Route 109
Copalis Beach, WA 98535
Phone (360) 289-2427

24215 Pacific Hwy S
Des Moines, WA 98198
Phone (206) 436-6380

31405 18th Ave S
Federal Way, WA 98003
Phone (253) 681-6600

8720 14th Ave S
Seattle, WA 98108
Phone (206) 762-3730

Organizations & group practices 5

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1386694982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703",
            "telephone_number": "253-681-6626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31405 18TH AVE S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035433",
            "telephone_number": "253-681-6600",
            "fax_number": "253-681-6645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYEON",
        "first_name": "JAI JUN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00044106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8453284",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00393772",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAI JUN",
            "last_name": "BYEON",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.