Individual provider Active NPI

Woo Sung Ahn, MD

  • Internal Medicine Physician
  • Lakewood, CA
National Provider Identifier
1396807806
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A51408 Issued in CA
Practice address
20145 S Pioneer Blvd
Lakewood, CA 90715-1051
Phone
(562) 916-5020
Fax
(562) 916-5022
NPI assigned
Dec 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A51408 CA Primary

Addresses

Primary practice location

20145 S Pioneer Blvd
Lakewood, CA 90715-1051

Mailing address

20145 S Pioneer Blvd
Lakewood, CA 90715-1051
Phone (562) 916-5020

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091111000572 CA Practitioner - Internal Medicine 6002851268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

20145 Pioneer Blvd
Lakewood, CA 90715-1051
Phone (562) 916-5020

20145 S Pioneer Blvd
Lakewood, CA 90715-1051

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A51408CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Woosung Ahn, M.D., Inc Internal Medicine CurrentSince Sep 30, 2009 Accepting new patients

Locations

20145 Pioneer Blvd
Lakewood, CA 90715
Phone (562) 916-5020

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: woosung.ahn@258578418958338.direct.elationemr.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Divine Home Health, Inc.La Mirada, CA, CCN 058330 Home health agency Operational/Managerial Control (100%) Sep 1, 2005

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396807806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20145 S PIONEER BLVD",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907151051",
            "telephone_number": "562-916-5020",
            "fax_number": "562-916-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20145 S PIONEER BLVD",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907151051",
            "telephone_number": "562-916-5020",
            "fax_number": "562-916-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHN",
        "first_name": "WOO SUNG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A51408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

Verify at the official NPI Registry.