NPIMap

Individual provider Active NPI

Mi-Young Um, PA-C

  • Medical Physician Assistant
  • Fayetteville, NC
National Provider Identifier
1578075206
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
1638 Owen Dr
Fayetteville, NC 28304-3424
Phone
(910) 615-4372
NPI assigned
Nov 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NC Primary

Addresses

Primary practice location

1638 Owen Dr
Fayetteville, NC 28304-3424

Mailing address

207 Shadow Rock LN
Mars, PA 16046-1703
Phone (630) 947-6519

Other practice location 1

101 Robeson St Ste 300
Fayetteville, NC 28301-5520
Phone (910) 615-3879

Other practice location 2

150 Robeson St
Fayetteville, NC 28301-5570
Phone (910) 615-1220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180221000122 NC Practitioner - Physician Assistant 3678834397 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke University Affiliated Physicians, Inc.Group PAC ID 3779489588, 452 clinicians

Practice addresses (Care Compare)

1901 Hillandale Rd
Durham, NC 27705-2664

3000 Rogers Rd
Wake Forest, NC 27587-5745

401 Irving Pkwy
Holly Springs, NC 27540-5301

5716 Fayetteville Rd
Durham, NC 27713-9661
Phone (919) 572-1868

7021 Harps Mill Rd
Raleigh, NC 27615-3240
Phone (919) 576-8480

Hospital & facility affiliations

  • Duke University Hospital Hospital, Durham, NC, CCN 340030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Health System, Inc. CurrentSince Jul 1, 2019 Accepting new patients
Duke University Affiliated Physicians, Inc. CurrentSince Apr 10, 2023 Accepting new patients
Duke University Affiliated Physicians, Inc. CurrentSince Apr 10, 2023 Accepting new patients
Duke University Health System, Inc. CurrentSince Jul 1, 2019 Accepting new patients
Duke University Affiliated Physicians, Inc. Past Accepting new patients

Locations

1821 Hillandale Rd
Ste 25A
Durham, NC 27705
Phone (919) 620-7300

1901 Hillandale Rd
Ste D
Durham, NC 27705
Phone (919) 383-4355

3400 Wake Forest Rd
Raleigh, NC 27609
Phone (919) 954-3000

Interoperability endpoints

  • Direct secure messaging: mum430896@direct.medicine.duke.edu

Organizations & group practices 7

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 6

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": "1509667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1578075206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 SHADOW ROCK LN",
            "city": "MARS",
            "state": "PA",
            "postal_code": "160461703",
            "telephone_number": "630-947-6519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043424",
            "telephone_number": "910-615-4372"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Robeson St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283015520",
            "country_code": "US",
            "telephone_number": "910-615-3879",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 Robeson St",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283015570",
            "country_code": "US",
            "telephone_number": "910-615-1220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UM",
        "first_name": "MI-YOUNG",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-03",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.