Organization Active NPI

Medplus Medical Group

  • Internal Medicine Physician
  • Fairfax, VA
National Provider Identifier
1710869581
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDPLUS MEDICAL GROUP
Practice address
10721 Main St Ste 204
Fairfax, VA 22030-6902
Phone
(571) 655-2267
NPI assigned
Jul 23, 2025
Last updated
Jul 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Authorized official

Name
Myoungjoo Chung
Title
Director
Phone
(571) 655-2267

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

10721 Main St Ste 204
Fairfax, VA 22030-6902

Mailing address

12584 Fair Village Way
Fairfax, VA 22033-6231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251002001597 DC Part B Supplier - Clinic/Group Practice 9133625734 Receives reassigned benefits from 1 practitioner
Practice locations: Fairfax, VA

National Provider Directory

National Provider Directory

Locations

10721 Main St
Ste 204
Fairfax, VA 22030
Phone (571) 414-0951

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1753228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753228800000",
    "number": "1710869581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12584 FAIR VILLAGE WAY",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220336231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10721 MAIN ST STE 204",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306902",
            "telephone_number": "571-655-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDPLUS MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-23",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "MYOUNGJOO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "571-655-2267"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.