Individual provider Active NPI

Bung Joo Choi, PA

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1851615371
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA20894 Issued in CA
Practice address
3612 1/2 E 1St St
Los Angeles, CA 90063-2326
Phone
(404) 433-3737
NPI assigned
Mar 26, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA20894 CA Primary

Addresses

Primary practice location

3612 1/2 E 1St St
Los Angeles, CA 90063-2326

Mailing address

3612 1/2 E 1St St
Los Angeles, CA 90063-2326
Phone (404) 433-3737

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100630000840 CA Practitioner - Physician Assistant 1153452461 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Southern California Keck School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bung Joo Choi Physician Assistant PCGroup PAC ID 2668994054, 3 clinicians

Practice addresses (Care Compare)

20556 W Deer Grass CT
Porter Ranch, CA 91326-4990
Phone (818) 207-0600

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA20894CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New Hope Podiatry Group Inc. PastSince Dec 29, 2024 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1269561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1851615371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3612 1/2 E 1ST ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900632326",
            "telephone_number": "404-433-3737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3612 1/2 E 1ST ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900632326",
            "telephone_number": "404-433-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "BUNG JOO",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-26",
        "last_updated": "2022-01-05",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA20894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.