Jong Chun Moon, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

00A356070 Issued in CA

Practice address

406 James St
Shafter, CA 93263-2035

Phone

(661) 746-5788

Fax

(661) 746-5273

NPI assigned

Dec 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

General Practice

Education

Other, 1968

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vanguard Medical Corporation 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (5 of 6)

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Vanguard Medical Corporation

  • Rural Health Clinic/Center
  • Shafter, CA
  • NPI 1609281310

  CA

  Medicare reassignment Care Compare group NPD
• Vanguard Medical Corporation

  • Rural Health Clinic/Center
  • Wasco, CA
  • NPI 1164270807
  Care Compare group NPD
• Vanguard Medical Corporation

  • Rural Health Clinic/Center
  • Wasco, CA
  • NPI 1558801829
  Care Compare group
• Vanguard Medical Corporation

  • Rural Health Clinic/Center
  • Arvin, CA
  • NPI 1942970124
  Care Compare group
• Bakersfield Memorial Hospital

  • Institutional Pharmacy
  • Bakersfield, CA
  • NPI 1144256363
  NPD (past)
• Jae J. Kim, M.D.

  • Primary Care Clinic/Center
  • Shafter, CA
  • NPI 1073796843
  NPD (past)
• San Joaquin Community Hospital

  • General Acute Care Hospital
  • Bakersfield, CA
  • NPI 1538157508
  NPD (past)

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760545925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 JAMES ST.",
            "city": "SHAFTER",
            "state": "CA",
            "postal_code": "93263",
            "telephone_number": "661-746-5788",
            "fax_number": "661-746-5273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 JAMES ST",
            "city": "SHAFTER",
            "state": "CA",
            "postal_code": "932632035",
            "telephone_number": "661-746-5788",
            "fax_number": "661-746-5273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "JONG",
        "middle_name": "CHUN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "00A356070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM53818F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Avery McManus, RD
• Debra Ann Metter, DO
• Michael Komin MD Medical Corportion
• Brittany Millwee
• Julia Montoya
• Bridgette Morton
• Nasr Mousa Botrous Mousa, DDS
• Brenda J Mulder, R.D.
• Christian O'Brian Munoz
• Monica Jeannemarian Murphy, MD

• All providers in Shafter, CA
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.