Individual provider Active NPI

Nancy Jeong-Sun Han, M.D.

  • Gastroenterology Physician
  • Fountain Valley, CA
National Provider Identifier
1609055300
Registry record updated Feb 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A99261 Issued in CA
Practice address
18035 Brookhurst St Ste 2100
Fountain Valley, CA 92708-6738
Phone
(657) 241-9090
Fax
(714) 665-4603
NPI assigned
Oct 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A99261 CA Primary

Addresses

Primary practice location

18035 Brookhurst St Ste 2100
Fountain Valley, CA 92708-6738

Mailing address

18035 Brookhurst St Ste 2100
Fountain Valley, CA 92708-6738
Phone (657) 241-9090

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20110920000645 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 6204982317 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Ohio Medical University, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

18035 Brookhurst St
Suite 2100
Fountain Valley, CA 92708-6738
Phone (657) 241-9090

Hospital & facility affiliations

  • Memorialcare Orange Coast Medical Center Hospital, Fountain Valley, CA, CCN 050678

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy31
Upper gastrointestinal (GI) endoscopy for acid reflux38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A99261CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Internal Medicine CurrentSince Apr 9, 2022 Accepting new patients
Healthcare Partners Affiliates Medical Group Internal Medicine Current Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 1, 2015 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 1, 2015 Accepting new patients
Bristol Park Medical Group, Inc Internal Medicine Past Accepting new patients
Talbert Medical Group, P.C. Internal Medicine Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

818 W Alondra Blvd
Compton, CA 90220
Phone (310) 537-1137

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

8311 Florence Ave
Downey, CA 90240
Phone (310) 923-4911

18035 Brookhurst St
Ste 1300
Fountain Valley, CA 92708
Phone (657) 241-9440

18035 Brookhurst St
Ste 2100
Fountain Valley, CA 92708
Phone (657) 241-9090

9930 Talbert Ave
Fountain Vly, CA 92708
Phone (714) 964-6229

1501 W Commonwealth Ave
Fullerton, CA 92833
Phone (714) 410-3100

19066 Magnolia St
Huntington Beach, CA 92646
Phone (714) 378-2225

4050 Barranca Pkwy
Ste 200
Irvine, CA 92604
Phone (949) 551-1090

500 Alamitos Ave
Long Beach, CA 90802
Phone (310) 432-5661

2925 Palo Verde Ave
Long Beach, CA 90815
Phone (562) 421-2757

601 Torrance Blvd
#1182
Redondo Beach, CA 90277

1002 N Fairview St
Santa Ana, CA 92703
Phone (714) 332-1069

13152 Newport Ave
Tustin, CA 92780
Phone (714) 442-4864

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: nancyhan@hcpca.allscriptsdirect.net

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 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": "1193702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1609055300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18035 BROOKHURST ST STE 2100",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086738",
            "telephone_number": "657-241-9090",
            "fax_number": "714-665-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18035 BROOKHURST ST STE 2100",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086738",
            "telephone_number": "657-241-9090",
            "fax_number": "714-665-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "NANCY",
        "middle_name": "JEONG-SUN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-30",
        "last_updated": "2023-02-03",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A99261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "25825 Vermont Ave",
            "city": "Harbor City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907103518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.