Individual provider Active NPI

Kyongeun Seo, DNP

  • Nurse Practitioner
  • Severn, MD
National Provider Identifier
1801673983
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R246277 Issued in MD
Practice address
8009 Battersea PL
Severn, MD 21144-2796
Phone
(201) 218-6787
NPI assigned
Sep 12, 2023
Last updated
Sep 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R246277 MD Primary

Addresses

Primary practice location

8009 Battersea PL
Severn, MD 21144-2796

Mailing address

8009 Battersea PL
Severn, MD 21144-2796
Phone (201) 218-6787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240309000240 MD Practitioner - Nurse Practitioner 3072959329 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Sinai Hospital of Baltimore, IncGroup PAC ID 0941112346, 373 clinicians
Synergy Medical Group LLCGroup PAC ID 0749644177, 102 clinicians

Practice addresses (Care Compare)

2401 E Belvedere Ave
Baltimore, MD 21215-5216

2435 W Belvedere Ave
Baltimore, MD 21215-5224

7001 N Charles St
Autumn Lake Healthcare at Ruxton
Towson, MD 21204-3730
Phone (410) 269-5100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R246277MDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore Inc Current Accepting new patients
Sinai Hospital of Baltimore Inc CurrentSince Mar 3, 2024 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Mar 3, 2024 Accepting new patients
Synergy Medical Group LLC CurrentSince Jan 11, 2026 Accepting new patients
Synergy Medical Group LLC CurrentSince Jan 11, 2026 Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

2435 W Belvedere Ave
Ste 56
Baltimore, MD 21215
Phone (410) 578-8632

5215 W Cedar Ln
Bethesda, MD 20814
Phone (301) 530-1600

1205 York Rd
Ste 11
Timonium, MD 21093
Phone (443) 325-0031

509 E Joppa Rd
Towson, MD 21286
Phone (301) 772-0484

7001 N Charles St
Towson, MD 21204
Phone (410) 269-5100

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 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": "1694476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1801673983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8009 BATTERSEA PL",
            "city": "SEVERN",
            "state": "MD",
            "postal_code": "211442796",
            "telephone_number": "201-218-6787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8009 BATTERSEA PL",
            "city": "SEVERN",
            "state": "MD",
            "postal_code": "211442796",
            "telephone_number": "201-218-6787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEO",
        "first_name": "KYONGEUN",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-12",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R246277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Severn, MD

Sources for this page

Verify at the official NPI Registry.