NPIMap

Individual provider Active NPI

Jungyoon Ro, CRNP

  • Acute Care Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1770964546
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP014916 Issued in PA
Practice address
3509 N Broad St
Philadelphia, PA 19140-4105
Phone
(215) 707-7200
Fax
(215) 707-3831
NPI assigned
Jun 17, 2015
Last updated
May 1, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP014916 PA Primary

Addresses

Primary practice location

3509 N Broad St
Philadelphia, PA 19140-4105

Mailing address

2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Phone (215) 707-7200

Other practice location 1

7604 Central Ave
Friends Hall, Suite #101
Philadelphia, PA 19111-2433
Phone (215) 728-3910

Other identifiers 1

IdentifierTypeStateIssuer
1007780130126MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151222001086 PA Practitioner - Nurse Practitioner 8325349061 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

3509 N Broad St
Philadelphia, PA 19140-4105
Phone (215) 707-2111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
49.71
Promoting interoperability
100
Improvement activities
40
Cost
74.23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc CurrentSince Mar 10, 2019 Accepting new patients
Temple Physician Inc. CurrentSince Feb 1, 2018 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Mar 10, 2019 Accepting new patients
Temple Physicians Inc CurrentSince Feb 1, 2018 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Temple Physicians Inc Current Accepting new patients

Locations

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

1331 E Wyoming Ave
Philadelphia, PA 19124
Phone (215) 537-7400

2450 W Hunting Park Ave
Philadelphia, PA 19129
Phone (215) 707-2433

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

3509 N Broad St
Philadelphia, PA 19140
Phone (215) 707-2433

7500 Central Ave
Philadelphia, PA 19111
Phone (215) 214-4100

7600 Central Ave
Philadelphia, PA 19111
Phone (215) 707-5522

7604 Central Ave
Ste 101
Philadelphia, PA 19111
Phone (215) 745-8989

Organizations & group practices 6

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.

Hospital & facility affiliations 8

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": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1770964546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-707-7200",
            "fax_number": "215-707-3831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404105",
            "telephone_number": "215-707-7200",
            "fax_number": "215-707-3831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7604 Central Ave",
            "address_2": "Friends Hall, Suite #101",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191112433",
            "country_code": "US",
            "telephone_number": "215-728-3910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RO",
        "first_name": "JUNGYOON",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-17",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP014916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007780130126",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.