Individual provider Active NPI

Bo Ram Chung, CRNA

  • Certified Registered Nurse Anesthetist
  • Lancaster, CA
National Provider Identifier
1720472020
Registry record updated Dec 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
95000417 Issued in CA
Practice address
1600 W Avenue J
Lancaster, CA 93534-2814
Phone
(661) 949-5000
NPI assigned
Mar 24, 2015
Last updated
Dec 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN194250 GA
Certified Registered Nurse Anesthetist 367500000X 95000417 CA Primary

Addresses

Primary practice location

1600 W Avenue J
Lancaster, CA 93534-2814

Mailing address

23638 Lyons Ave Ste 153
Newhall, CA 91321-2513
Phone (404) 642-0900

Other practice location 1

100 W California Blvd
Pasadena, CA 91105
Phone (404) 642-0900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150519000683 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456671247 Reassigns benefits to 1 organization
I20160620000969 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456671247 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Valley Medical GroupGroup PAC ID 3577465368, 104 clinicians
Anesthesia Partners of North ValleyGroup PAC ID 3678561263, 20 clinicians
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians

Practice addresses (Care Compare)

100 W California Blvd
Pasadena, CA 91105-3010
Phone (626) 440-9161

1600 W Ave J
Lancaster, CA 93534-2814
Phone (661) 949-5000

23845 McBean Pkwy
Valencia, CA 91355-2001
Phone (661) 200-1705

25751 McBean Pkwy
Suite 105
Valencia, CA 91355-3701
Phone (661) 200-1315

26357 McBean Pkwy
Suite 100
Santa Clarita, CA 91355-4489
Phone (661) 799-8300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.18 of 100Reported as group
Quality
54.44
Improvement activities
40
Cost
76.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
95000417CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Relevo Health PC CurrentSince Sep 23, 2023 Accepting new patients
Cep America - Anesthesia PC CurrentSince Mar 1, 2024 Accepting new patients
Metro Nursing Anesthesia Services Inc. Nurse Anesthetist, Certified Registered CurrentSince Jul 14, 2022 Accepting new patients
Relevo Health PC CurrentSince Sep 23, 2023 Accepting new patients
Xenon Anesthesia of Georgia LLC CurrentSince Oct 28, 2015 Accepting new patients
Universal Pain Management Medical Corporation CurrentSince Sep 8, 2021 Accepting new patients
Cep America - Anesthesia PC CurrentSince Mar 1, 2024 Accepting new patients
Cep America - Anesthesia, PC Current Accepting new patients
Pacific Valley Medical Group CurrentSince May 1, 2021 Accepting new patients
Universal Pain Management Medical Corp CurrentSince Sep 8, 2021 Accepting new patients
Cep America - Anesthesia PC Past Accepting new patients
Metro Nursing Anesthesia Services Inc Nurse Anesthetist, Certified Registered PastSince Dec 22, 2020 Accepting new patients

Locations

2725 16th St
Bakersfield, CA 93301
Phone (661) 401-2800

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

15503 Ventura Blvd
Ste 200
Encino, CA 91436
Phone (818) 788-7288

1600 W Avenue J
Lancaster, CA 93534
Phone (661) 726-6254

420 E 3rd St
Ste 110
Los Angeles, CA 90013
Phone (213) 617-9194

6464 W Sunset Blvd
Ste 790
Los Angeles, CA 90028
Phone (323) 417-0336

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

815 Auto Center Dr
Palmdale, CA 93551
Phone (661) 206-6262

819 Auto Center Dr
Palmdale, CA 93551
Phone (661) 267-6876

100 W California Blvd
Pasadena, CA 91105
Phone (626) 397-3445

333 S Arroyo Pkwy
Fl 3
Pasadena, CA 91105
Phone (626) 440-9161

797 S Fair Oaks Ave
Pasadena, CA 91105
Phone (626) 535-2434

23845 McBean Pkwy
Valencia, CA 91355
Phone (661) 200-2000

25751 McBean Pkwy
Valencia, CA 91355
Phone (661) 200-1294

25751 McBean Pkwy
Ste 105
Valencia, CA 91355
Phone (661) 200-1315

26357 McBean Pkwy
Ste 100
Valencia, CA 91355
Phone (661) 799-8300

28212 Kelly Johnson Pkwy
Ste 155
Valencia, CA 91355
Phone (661) 367-9788

3400 McClure Bridge Rd
Ste A102
Duluth, GA 30096
Phone (917) 621-6854

111 Town Square Pl
Ste 420
Jersey City, NJ 07310
Phone (201) 258-4700

Organizations & group practices 13

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.

View all 13

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": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1720472020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23638 LYONS AVE STE 153",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913212513",
            "telephone_number": "404-642-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W AVENUE J",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342814",
            "telephone_number": "661-949-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 W California Blvd",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "91105",
            "country_code": "US",
            "telephone_number": "404-642-0900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "BO RAM",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-24",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN194250",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95000417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.