Individual provider Active NPI

Lucy Min Joo, DO

  • Gastroenterology Physician
  • Turnersville, NJ
National Provider Identifier
1669813804
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
25MB09763200 Issued in NJ
Practice address
188 Fries Mill Rd Ste N1
Turnersville, NJ 08012-2055
Phone
(856) 783-2241
NPI assigned
Jul 16, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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 25MB09763200 NJ Primary

Addresses

Primary practice location

188 Fries Mill Rd Ste N1
Turnersville, NJ 08012-2055

Mailing address

188 Fries Mill Rd Ste N1
Turnersville, NJ 08012-2055
Phone (856) 783-2241

Other practice location 1

2201 Chapel Ave W Ste 300
Cherry Hill, NJ 08002-2048
Phone (856) 783-2241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20190813000061 NJ Practitioner - Gastroenterology 2567799646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Rowan University School of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kennedy Medical Group Practice, P.C.Group PAC ID 2860616877, 417 clinicians

Practice addresses (Care Compare)

333 Laurel Oak Rd
Voorhees, NJ 08043-4453
Phone (844) 542-2273

Hospital & facility affiliations

  • Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086
  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy133
Upper gastrointestinal (GI) endoscopy for acid reflux155

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB09763200NJMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Medical Group Practice PC CurrentSince Sep 1, 2019 Accepting new patients
Kennedy Medical Group Practice, P.C. CurrentSince Sep 1, 2019 Accepting new patients
Kennedy Medical Group Practice, P.C. CurrentSince Jun 15, 2021 Accepting new patients
Kennedy Medical Group Practice P.C. Past Accepting new patients

Locations

2201 Chapel Ave W
Ste 300
Cherry Hill, NJ 08002
Phone (856) 783-2241

2211 Chapel Ave W
Ste 401
Cherry Hill, NJ 08002
Phone (856) 783-2241

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

188 Fries Mill Rd
Ste N1
Turnersville, NJ 08012
Phone (609) 261-7023

333 Laurel Oak Rd
Voorhees, NJ 08043
Phone (856) 344-7360

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 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": "1373932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1669813804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 FRIES MILL RD STE N1",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "080122055",
            "telephone_number": "856-783-2241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 FRIES MILL RD STE N1",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "080122055",
            "telephone_number": "856-783-2241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 Chapel Ave W Ste 300",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080022048",
            "country_code": "US",
            "telephone_number": "856-783-2241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOO",
        "first_name": "LUCY",
        "middle_name": "MIN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-16",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MB09763200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Turnersville, NJ

Sources for this page

Verify at the official NPI Registry.