Individual provider Active NPI

Jane Y Chung, MD

  • Internal Medicine Physician
  • Clackamas, OR
National Provider Identifier
1700993615
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD25137 Issued in OR
Practice address
10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone
(503) 571-8049
NPI assigned
Aug 24, 2006
Last updated
Apr 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD25137 OR Primary

Addresses

Primary practice location

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970

Mailing address

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE) Northwest Permanente PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080411000194 OR Practitioner - Internal Medicine 1153408372 Reassigns benefits to 1 organization
I20230501001839 WA Practitioner - Internal Medicine 1153408372 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Internal Medicine CurrentSince Nov 2, 2015 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Nov 2, 2015 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Internal Medicine CurrentSince Jan 26, 2023 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

10180 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2880

2701 NW Vaughn St
Portland, OR 97210
Phone (503) 499-5200

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1700993615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10180 SE SUNNYSIDE RD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970158970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10180 SE SUNNYSIDE RD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970158970",
            "telephone_number": "503-571-8049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "JANE",
        "middle_name": "Y",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD25137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Northwest Permanente PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2701 NW Vaughn St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972105311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

Verify at the official NPI Registry.