Individual provider Active NPI

Mary S Jung, M.D.

  • Dermatology Physician
  • Orange, CA
National Provider Identifier
1821032871
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A73312 Issued in CA
Practice address
1506 E Chapman Ave
Orange, CA 92866-2231
Phone
(714) 538-8556
Fax
(714) 538-1082
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A73312 CA Primary

Addresses

Primary practice location

1506 E Chapman Ave
Orange, CA 92866-2231

Mailing address

1506 E Chapman Ave
Orange, CA 92866-2231
Phone (714) 538-8556

Other identifiers 2

IdentifierTypeStateIssuer
A73312OtherCAMEDICAL LICENSE
00A733120MedicaidCA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040804001214 CA Practitioner - Internal Medicine 5193796977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17601 17TH St
Suite 110
Tustin, CA 92780-1949
Phone (714) 790-0005

Merit-based Incentive Payment System (MIPS)

Final score
91.14 of 100Reported as individual
Quality
82.29
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision49
Removal of skin lesions593
Removal of skin cancer167
Removal of nail tissue1-10
Skin biopsy128

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A73312CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary S Jung MD Inc Dermatology CurrentSince Jul 12, 2006 Accepting new patients

Locations

1506 E Chapman Ave
Orange, CA 92866
Phone (714) 538-8556

17601 17th St
Ste 110
Tustin, CA 92780
Phone (714) 538-8556

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191196800000",
    "number": "1821032871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928662231",
            "telephone_number": "714-538-8556",
            "fax_number": "714-538-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928662231",
            "telephone_number": "714-538-8556",
            "fax_number": "714-538-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "MARY",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2007-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A73312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A73312",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A733120",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.