Seung Jae Moon, MD
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Mechanisburg, PA
NPI 1689324279 · NPPES record last updated May 8, 2025
Key facts
- NPI
- 1689324279
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 2020 Technology Parkway
Mechanisburg, PA 17050 - Phone
- (717) 731-0101
- NPI assigned
- Mar 25, 2022
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250711003693 | PA | Order and Referring Only - Cardiovascular Disease (Cardiology) |
9931614658 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
2020 Technology Parkway
Mechanisburg, PA 17050
Mailing address
3600 Forbes Avenue Forbes Tower Plaza Level Suite 140
Pittsburgh, PA 15213
Phone (929) 437-9050
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.