Individual provider Active NPI

Justin Sze-Chung Lo, D.O.

  • Emergency Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1740667526
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
007900 Issued in AZ
Practice address
1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone
(480) 500-2540
Fax
(623) 201-7954
NPI assigned
Apr 30, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OP61155048 WA
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 007900 AZ Primary

Addresses

Primary practice location

1111 E McDowell Rd
Phoenix, AZ 85006-2612

Mailing address

5740 Southwood Dr
Lake Oswego, OR 97035-6736
Phone (503) 539-9132

Other practice location 1

5740 Southwood Dr
Lake Oswego, OR 97035-6736
Phone (503) 539-9132

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20220830004604 WA Practitioner - Emergency Medicine 9032407598 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

21601 76TH Ave W
Edmonds, WA 98026-7507
Phone (425) 640-4100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
007900AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC Emergency Medicine CurrentSince Sep 1, 2022 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group CurrentSince Jun 15, 2023 Accepting new patients
Franciscan Medical Group CurrentSince Jun 15, 2023 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Sep 1, 2022 Accepting new patients

Locations

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

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

21601 76th Ave W
Edmonds, WA 98026
Phone (425) 640-4000

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Organizations & group practices 5

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": "1430352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1740667526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5740 SOUTHWOOD DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970356736",
            "telephone_number": "503-539-9132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E MCDOWELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062612",
            "telephone_number": "480-500-2540",
            "fax_number": "623-201-7954"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5740 Southwood Dr",
            "address_purpose": "LOCATION",
            "city": "Lake Oswego",
            "state": "OR",
            "postal_code": "970356736",
            "country_code": "US",
            "telephone_number": "503-539-9132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LO",
        "first_name": "JUSTIN",
        "middle_name": "SZE-CHUNG",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-30",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "OP61155048",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "007900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.