Edward C Pyun Jr., MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036111344 Issued in IL

Practice address

5668 E State St
Rockford, IL 61108-2464

Phone

(815) 229-7580

NPI assigned

Sep 11, 2006

Last updated

Oct 2, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

General Surgery

Education

Northeastern Ohio University College of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intermountain Medical Group Denver LLCGroup PAC ID 0840513552, 571 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Medical Center LLC Hospital, Lafayette, CO, CCN 060116

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Intermountain Medical Group Denver, LLC

  • Family Medicine Physician
  • Denver, CO
  • NPI 1083021083
  Medicare reassignment Care Compare group NPD
• Intermountain Medical Group Denver, LLC

  dba Orthopedic Centers of Colorado - Saint Joseph

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Denver, CO
  • NPI 1083598874
  NPD
• Intermountain Medical Group Denver, LLC

  dba Wheat Ridge Clinic - Maternal Fetal Medicine

  • Maternal & Fetal Medicine Physician
  • Wheat Ridge, CO
  • NPI 1477170421
  NPD
• Good Samaritan Medical Center, LLC

  dba Good Samaritan Medical Center

  • General Acute Care Hospital
  • Lafayette, CO
  • NPI 1407845035
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Good Samaritan Medical Center, LLC

  dba Good Samaritan Medical Center

  • General Acute Care Hospital
  • Lafayette, CO
  • NPI 1407845035
  Care Compare affiliation

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443744000000",
    "number": "1386748473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5668 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082464",
            "telephone_number": "815-229-7580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5668 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082464",
            "telephone_number": "815-229-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PYUN",
        "first_name": "EDWARD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2015-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036111344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036111344",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RAILROAD MED",
            "identifier": "P00198742",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pacita Marie Pumilia, B.S.D.D.S.
• Michael Puruckherr, MD
• Denise Purvis, LCPC
• Noel M Pycior, FNP-BC
• Patrick J Pyka, MPT
• Richard J. Pyzynski, D.D.S.
• Abdulmateen Qaisar, CRNA
• Assad Qasim, DMD
• Zaher Qassem, MD
• Zeeshan Qazi, MD

• Surgery Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; 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.