Individual provider Active NPI

Sun Young Moon, M.D.

  • Neurology Physician
  • Frisco, TX
National Provider Identifier
1609255058
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
U6763 Issued in OR
Practice address
12500 Dallas Pkwy FL 1
Frisco, TX 75033-4231
Phone
(469) 604-9000
NPI assigned
May 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X A147459 CA
Student in an Organized Health Care Education/Training Program 390200000X
Neurology Physician 2084N0400X U6763 OR Primary

Addresses

Primary practice location

12500 Dallas Pkwy FL 1
Frisco, TX 75033-4231

Mailing address

12500 Dallas Pkwy FL 1
Frisco, TX 75033-4231
Phone (469) 604-9000

Other names 1

  • Sun Young Yang Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address smoon1376209@oc.providencedirect.org
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240510002858 TX Practitioner - Neurology 5698009207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
New York University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12400 Dallas Pkwy
Frisco, TX 75033-4224
Phone (469) 604-9000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A147459CAMDNeurology Physician
U6763ORMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Apr 3, 2024 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Apr 3, 2024 Accepting new patients
University of Texas Southwestern Medical Center at Dallas PastSince Jul 28, 2024 Accepting new patients

Locations

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

12500 Dallas Pkwy
Fl 1
Frisco, TX 75033
Phone (469) 604-9000

12400 Dallas Pkwy
Frisco, TX 75033
Phone (469) 495-2000

3621 22nd St
Ste 400
Lubbock, TX 79410
Phone (806) 791-8484

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • Direct secure messaging: smoon4166493@ghc.direct-ci.net

Organizations & group practices 4

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": "1431993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1609255058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12500 DALLAS PKWY FL 1",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750334231",
            "telephone_number": "469-604-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12500 DALLAS PKWY FL 1",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750334231",
            "telephone_number": "469-604-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "SUN",
        "middle_name": "YOUNG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-19",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A147459",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "U6763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smoon1376209@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1510 Division St Ste 180",
            "city": "Oregon City",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970452551",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9505 S Steele St",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984441858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SUN",
            "last_name": "YANG",
            "middle_name": "YOUNG",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.