Active NPI
Myung H Jung, OD
- Optometrist
- Chehalis, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OD60394858
- Practice address
- 2517 NE Kresky Ave
Chehalis, WA 98532-2409 - Phone
- (360) 748-8632
- Fax
- (360) 748-3869
- NPI assigned
- Jul 17, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OD60394858 | WA | Primary |
| Optometrist | 152W00000X | AT3523 | OR | |
| Optometrist | 152W00000X | 007851 | NY | |
| Optometrist | 152W00000X | 27OA00642700 | NJ | |
| Optometrist | 152W00000X | 3523AT | OR |
Addresses
Primary practice location
2517 NE Kresky Ave
Chehalis, WA 98532-2409
Mailing address
PO Box 1506
Chehalis, WA 98532-0409
Phone (360) 242-3008
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750636726 | Medicaid | OR | |
| 2060397 | Medicaid | WA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | myung.jung.p1@direct.pcli.nextgenshare.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131212001304 | OR | Practitioner - Optometry | 5496982738 | Reassigns benefits to 1 organization |
| I20160614001714 | WA | Practitioner - Optometry | 5496982738 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- State University of New York - State College Optometry, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pacific Cataract and Laser Institute Inc PC
Practice addresses (Care Compare)
1331 NW Lovejoy St
Suite 750
Portland, OR 97209-2799
Phone (503) 535-2883
2517 NE Kresky Ave
Chehalis, WA 98532-2433
Phone (360) 748-8632
9309 NE 86TH St
Vancouver, WA 98662-2100
Phone (360) 694-2544
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 40 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27OA00642700 | NJ | MD | Optometrist |
| 007851 | NY | MD | Optometrist |
| AT3523 | OR | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Cataract and Laser Institute Inc PC | Current | Accepting new patients | |
| Pacific Cataract and Laser Institute, Inc., P.C. | Current | Accepting new patients | |
| Pacific Cataract and Laser Institute Inc PC | Current | Accepting new patients | |
| Pacific Cataract and Laser Institute Inc PC | Current | Accepting new patients | |
| Pacific Cataract and Laser Institute, Inc., P.C. | Current | Accepting new patients | |
| Pacific Cataract and Laser Institute, Inc., P.C. | Current | Accepting new patients | |
| Pacific Cataract and Laser Institute, Inc., P.C. | Past | Accepting new patients | |
| Pacific Cataract and Laser Institute, Inc., P.C. | Past | Accepting new patients |
Locations
1331 NW Lovejoy St
Ste 750
Portland, OR 97209
Phone (503) 535-2883
19801 SW 72nd Ave
Ste 150
Tualatin, OR 97062
Phone (503) 691-2283
2606 116th Ave NE
Ste 100
Bellevue, WA 98004
Phone (425) 462-7664
4330 Mitchell Way
Bellingham, WA 98226
Phone (360) 736-6860
2517 NE Kresky Ave
Chehalis, WA 98532
Phone (360) 748-8632
6695 W Rio Grande Ave
Kennewick, WA 99336
Phone (509) 736-0826
115 New View Ct NE
Olympia, WA 98506
Phone (360) 252-1642
9598 Mickelberry Rd NW
Silverdale, WA 98383
Phone (360) 698-5062
16818 E Desmet Ct
Spokane Valley, WA 99216
Phone (360) 242-3008
2915 S Alder St
Tacoma, WA 98409
Phone (253) 473-0275
2205 NE 129th St
Vancouver, WA 98686
Phone (360) 450-6644
3900 Kern Rd
Yakima, WA 98902
Phone (509) 966-1356
Organizations & group practices 8
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.
-
- Ambulatory Surgical Clinic/Center
- Bellevue, WA
- NPI 1306013925
WA
-
- Ambulatory Surgical Clinic/Center
- Tualatin, OR
- NPI 1265609945
OR
-
- Ambulatory Surgical Clinic/Center
- Chehalis, WA
- NPI 1487821633
-
- Ambulatory Surgical Clinic/Center
- Vancouver, WA
- NPI 1659548329
-
- Ophthalmologic Surgery Clinic/Center
- Auburn, WA
- NPI 1528814647
-
- Ambulatory Surgical Clinic/Center
- Kennewick, WA
- NPI 1619144607
-
- Ambulatory Surgical Clinic/Center
- Chehalis, WA
- NPI 1114978848
-
- Ambulatory Surgical Clinic/Center
- Lacey, WA
- NPI 1215178835
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607299200000",
"number": "1750636726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1506",
"city": "CHEHALIS",
"state": "WA",
"postal_code": "985320409",
"telephone_number": "360-242-3008",
"fax_number": "360-807-7687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2517 NE KRESKY AVE",
"city": "CHEHALIS",
"state": "WA",
"postal_code": "985322409",
"telephone_number": "360-748-8632",
"fax_number": "360-748-3869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUNG",
"first_name": "MYUNG",
"middle_name": "H",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-17",
"last_updated": "2020-12-07",
"certification_date": "2020-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "OD60394858",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OR",
"license": "AT3523",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "007851",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NJ",
"license": "27OA00642700",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OR",
"license": "3523AT",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1750636726",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2060397",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "myung.jung.p1@direct.pcli.nextgenshare.com",
"affiliation": "N",
"address_1": "2517 NE Kresky Ave",
"city": "Chehalis",
"state": "WA",
"country_code": "US",
"postal_code": "985322409",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Chehalis, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.