Individual provider Active NPI

Jen Sun, M.D.

  • Anesthesiology Physician
  • Las Vegas, NV
National Provider Identifier
1467676049
Registry record updated Aug 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A82642 Issued in CA
Practice address
8550 W Charleston Blvd
#102-136
Las Vegas, NV 89117-9210
Phone
(206) 948-2468
Fax
(206) 260-8833
NPI assigned
Apr 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2011

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A82642 CA Primary
Anesthesiology Physician 207L00000X MD00041400 WA
Anesthesiology Physician 207L00000X 46152020 WI
Anesthesiology Physician 207L00000X MD420604 PA
Anesthesiology Physician 207L00000X 31265 AZ
Anesthesiology Physician 207L00000X 01057989A IN
Anesthesiology Physician 207L00000X 60621 GA
Anesthesiology Physician 207L00000X 36.120088 IL
Anesthesiology Physician 207L00000X 234612 MA
Anesthesiology Physician 207L00000X 4301091370 MI
Anesthesiology Physician 207L00000X 11634 MT
Anesthesiology Physician 207L00000X 12689 NV
Anesthesiology Physician 207L00000X 247361 NY
Anesthesiology Physician 207L00000X MD28246 OR
Anesthesiology Physician 207L00000X 23292 WV

Addresses

Primary practice location

8550 W Charleston Blvd
#102-136
Las Vegas, NV 89117-9210

Mailing address

210 N Tustin Ave
Santa Ana, CA 92705-3807
Phone (800) 883-7243

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
I20041022001041 CA Practitioner - Anesthesiology 4981689619 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Meharry Medical College School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ventura County Anesthesia Medical Group, Inc.Group PAC ID 7113173543, 16 clinicians

Practice addresses (Care Compare)

3291 Loma Vista Rd
Ventura, CA 93003-3099
Phone (805) 652-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.49 of 100Reported as group
Quality
35.47
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31265AZMDAnesthesiology Physician
A82642CAMDAnesthesiology Physician
60621GAMDAnesthesiology Physician
36.120088ILMDAnesthesiology Physician
01057989AINMDAnesthesiology Physician
234612MAMDAnesthesiology Physician
4301091370MIMDAnesthesiology Physician
11634MTMDAnesthesiology Physician
12689NVMDAnesthesiology Physician
247361NYMDAnesthesiology Physician
MD28246ORMDAnesthesiology Physician
MD420604PAMDAnesthesiology Physician
MD00041400WAMDAnesthesiology Physician
46152020WIMDAnesthesiology Physician
23292WVMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Springs Anesthesia Services, PC Anesthesiology CurrentSince Mar 17, 2023 Accepting new patients
Ventura County Anesthesia Medical Group, Inc. Anesthesiology CurrentSince Oct 6, 2016 Accepting new patients
Providence Wa Anesthesia Services, P.C. Anesthesiology Past Accepting new patients

Locations

2309 Antonio Ave
Camarillo, CA 93010
Phone (805) 389-5655

3116 W March Ln
Ste 200
Stockton, CA 95219
Phone (510) 537-1234

3291 Loma Vista Rd
Ventura, CA 93003
Phone (805) 652-6000

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 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": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313020800000",
    "number": "1467676049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053807",
            "telephone_number": "800-883-7243",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 W CHARLESTON BLVD",
            "address_2": "#102-136",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891179210",
            "telephone_number": "206-948-2468",
            "fax_number": "206-260-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUN",
        "first_name": "JEN",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2011-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A82642",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD00041400",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "46152020",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD420604",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "31265",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01057989A",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "60621",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "36.120088",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "234612",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301091370",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MT",
            "license": "11634",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NV",
            "license": "12689",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "247361",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD28246",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WV",
            "license": "23292",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.