Individual provider Active NPI

Sang Won, M.D.

  • Family Medicine Physician
  • Lynnwood, WA
National Provider Identifier
1760918205
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
60984656 Issued in WA
Practice address
19401 40TH Ave W Ste 230
Lynnwood, WA 98036-5675
Phone
(425) 744-7153
NPI assigned
May 3, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 60984656 WA Primary

Addresses

Primary practice location

19401 40TH Ave W Ste 230
Lynnwood, WA 98036-5675

Mailing address

19401 40TH Ave W Ste 230
Lynnwood, WA 98036-5675

Other practice location 1

26520 Cactus Ave
Rm A1005 / Family Medicine Residency
Moreno Valley, CA 92555-3927
Phone (951) 486-5914

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address swon1347156@wm.providencedirect.org

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
I20200720000372 WA Practitioner - Family Practice 1658795091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Pennsylvania State University College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacmed ClinicsGroup PAC ID 2466350657, 211 clinicians
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

19401 40TH Ave W
Suite 230
Lynnwood, WA 98036-5675
Phone (425) 744-7153

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

  • Swedish Edmonds Hospital Hospital, Edmonds, WA, CCN 500026
  • Providence Regional Medical Center Everett Hospital, Everett, WA, CCN 500014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60984656WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacmed Clinics Current Accepting new patients
Pacmed Clinics CurrentSince Aug 31, 2020 Accepting new patients

Locations

1909 214th St SE
Ste 300
Bothell, WA 98021
Phone (425) 412-6335

19401 40th Ave W
Ste 230
Lynnwood, WA 98036
Phone (425) 744-7153

220 15th Ave SE
Puyallup, WA 98372
Phone (253) 435-3400

1101 Madison St
Ste 301
Seattle, WA 98104
Phone (206) 505-1101

1200 12th Ave S
Seattle, WA 98144
Phone (206) 326-2400

Organizations & group practices 3

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 4

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": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1760918205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19401 40TH AVE W STE 230",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980365675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19401 40TH AVE W STE 230",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980365675",
            "telephone_number": "425-744-7153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26520 Cactus Ave",
            "address_2": "Rm A1005 / Family Medicine Residency",
            "address_purpose": "LOCATION",
            "city": "Moreno Valley",
            "state": "CA",
            "postal_code": "925553927",
            "country_code": "US",
            "telephone_number": "951-486-5914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WON",
        "first_name": "SANG",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-03",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "60984656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swon1347156@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "19401 40th Ave W Ste 230",
            "city": "Lynnwood",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980365675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

Verify at the official NPI Registry.