Individual provider Active NPI

Daniel Jeung, MD

  • Internal Medicine Physician
  • Ypsilanti, MI
National Provider Identifier
1417375452
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301105052 Issued in MI
Practice address
5361 McAuley Dr
Ypsilanti, MI 48197-1011
Phone
(734) 712-1300
Fax
(734) 222-3665
NPI assigned
Apr 6, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 4301105052 MI Primary

Addresses

Primary practice location

5361 McAuley Dr
Ypsilanti, MI 48197-1011

Mailing address

5361 McAuley Dr
Ypsilanti, MI 48197-1011
Phone (734) 712-1300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20170721003005 MI Practitioner - Internal Medicine 9537385778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Toledo Medical College, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

5361 McAuley Dr
Ypsilanti, MI 48197-1011
Phone (734) 712-1300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301105052MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Service Corporation CurrentSince Aug 1, 2017 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Services Corporation CurrentSince Aug 1, 2017 Accepting new patients

Locations

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

5361 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-1300

Interoperability endpoints

  • Direct secure messaging: djeung32508@direct.trinity-health.org

Organizations & group practices 3

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 5

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": "1396742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1417375452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5361 MCAULEY DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971011",
            "telephone_number": "734-712-1300",
            "fax_number": "734-222-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5361 MCAULEY DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971011",
            "telephone_number": "734-712-1300",
            "fax_number": "734-222-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEUNG",
        "first_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301105052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.