Chan Suk Jung

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

76062 Issued in CA

Practice address

850 Colorado Blvd
Ste 104
Los Angeles, CA 90041-1762

Phone

(213) 553-1884

Fax

(213) 236-9662

NPI assigned

Nov 15, 2010

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

KCS, Inc.Group PAC ID 0446495105, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chansuk.jung.p1@direct.kcs.nextgenshare.com

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.

• KCS, Inc.

  • Federally Qualified Health Center (FQHC)
  • Buena Park, CA
  • NPI 1861525602
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1811298391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 COLORADO BLVD STE 104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900411762",
            "telephone_number": "626-676-1378",
            "fax_number": "213-325-6749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 COLORADO BLVD",
            "address_2": "STE 104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900411762",
            "telephone_number": "213-553-1884",
            "fax_number": "213-236-9662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "CHAN SUK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-15",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "76062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jung Yoon Chang Dental Corp
• Ae Young Jung
• Ariel Eunji Jung, MD
• Brennan Jung
• Carrie Elizabeth Jung, M.D.
• Chanhwi Jung, L.AC
• Charles J. Jung, D.M.D.
• Christina Jung
• Christina Jung, MD, MPH
• Christina Jung, LCSW

• Clinical Social Worker in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.