Individual provider Active NPI

John Young Jun, M.D.

  • Anesthesiology Physician
  • McLean, VA
National Provider Identifier
1639352628
Registry record updated Dec 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
0101252949 Issued in VA
Practice address
8008 Westpark Dr
Kaiser Permanente Tysons Corner Medical Center
MC Lean, VA 22102-3109
Phone
(703) 287-6400
NPI assigned
Dec 12, 2007
Last updated
Dec 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MT189075 PA
Anesthesiology Physician 207L00000X 0101252949 VA Primary

Addresses

Primary practice location

8008 Westpark Dr
Kaiser Permanente Tysons Corner Medical Center
MC Lean, VA 22102-3109

Mailing address

2101 E Jefferson St
Kaiser Permanente Medicare Enrollment
Rockville, MD 20852-4908
Phone (301) 816-2424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20170627003140 MD Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 5991998767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Interventional Pain Management
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

827 Linden Ave
Baltimore, MD 21201-4606
Phone (667) 214-1616

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT189075PAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Anesthesiology Associates,P.a. CurrentSince May 20, 2017 Accepting new patients
University of Maryland Anesthesiology Associates, P.a. Anesthesiology CurrentSince May 20, 2017 Accepting new patients
Riverside Anesthesia Associates, LTD Anesthesiology Past Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

611 S Charles St
Baltimore, MD 21230
Phone (410) 328-6331

827 Linden Ave
Baltimore, MD 21201
Phone (410) 225-8100

2200 Kernan Dr
Woodlawn, MD 21207
Phone (410) 448-2500

Interoperability endpoints

  • Direct secure messaging: jjun480516@direct.umm.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1197417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354752000000",
    "number": "1639352628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 E JEFFERSON ST",
            "address_2": "KAISER PERMANENTE MEDICARE ENROLLMENT",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524908",
            "telephone_number": "301-816-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8008 WESTPARK DR",
            "address_2": "KAISER PERMANENTE TYSONS CORNER MEDICAL CENTER",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023109",
            "telephone_number": "703-287-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUN",
        "first_name": "JOHN",
        "middle_name": "YOUNG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-12",
        "last_updated": "2012-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MT189075",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101252949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McLean, VA

Sources for this page

Verify at the official NPI Registry.