Stacey Pun, MD

Primary specialty

Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X

License

A160550 Issued in CA

Practice address

1127 Wilshire Blvd Ste 600
Los Angeles, CA 90017-3907

Phone

(213) 278-0021

Fax

(213) 278-0973

NPI assigned

Oct 30, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

DermatologyAlso: Pathology

Education

University of Southern California Keck School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ak Derm CorpGroup PAC ID 3678806882, 3 clinicians

Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625

Merit-based Incentive Payment System (MIPS)

Final score

89.14 of 100Reported as group

Quality

84.79

Promoting interoperability

99

Improvement activities

40

Cost

73.15

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Ak Derm Corp

  • Dermatology Physician
  • Encino, CA
  • NPI 1013475805
  Medicare reassignment Care Compare group NPD
• Cedars-Sinai Medical Care Foundation

  • Specialist
  • Los Angeles, CA
  • NPI 1316984388
  Medicare reassignment Care Compare group NPD
• Csi Medical Group

  • MOHS-Micrographic Surgery Physician
  • San Pedro, CA
  • NPI 1871909804

  Dermatology

  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Cedars-Sinai Medical Care Foundation

  • Anesthesiology Physician
  • Los Angeles, CA
  • NPI 1043826720
  NPD
• David B. Friedman, MD, Inc

  • Procedural Dermatology Physician
  • Anaheim, CA
  • NPI 1164620795
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Panorama City, CA
  • NPI 1407888928
  NPD
• Carlsbad and Vista Dermatology, Inc.

  • Dermatology Physician
  • Vista, CA
  • NPI 1124328505
  NPD (past)
• Cary Edward Feibleman MD Inc

  • Dermatology Physician
  • Long Beach, CA
  • NPI 1982796389
  NPD (past)
• Susan Goodlerner MD Inc

  • Dermatology Physician
  • Torrance, CA
  • NPI 1487894457
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cedars-Sinai Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1639172372
  Care Compare affiliation
• Cedars-Sinai Medical Center

  • General Acute Care Hospital
  • West Hollywood, CA
  • NPI 1891940326
  Care Compare affiliation

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1851763783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6399 SAN IGNACIO AVE STE 120",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951191215",
            "telephone_number": "310-909-4728",
            "fax_number": "408-904-7730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 WILSHIRE BLVD STE 600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900173907",
            "telephone_number": "213-278-0021",
            "fax_number": "213-278-0973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1165 N Euclid St",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928011938",
            "country_code": "US",
            "telephone_number": "714-991-9900",
            "fax_number": "714-991-9496",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Congress St Ste 320",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911053084",
            "country_code": "US",
            "telephone_number": "626-585-9474",
            "fax_number": "626-585-9480",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 E 28th St Ste 311",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908062780",
            "country_code": "US",
            "telephone_number": "562-595-4777",
            "fax_number": "562-424-9644",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "289 W Huntington Dr Ste 208",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "CA",
            "postal_code": "910073495",
            "country_code": "US",
            "telephone_number": "626-446-8809",
            "fax_number": "626-446-8268",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23451 Madison St Ste 330",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905054762",
            "country_code": "US",
            "telephone_number": "310-375-9994",
            "fax_number": "310-378-0789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4201 Torrance Blvd Ste 640",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905034524",
            "country_code": "US",
            "telephone_number": "310-543-4444",
            "fax_number": "310-543-4446",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1360 W 6th St Ste 370",
            "address_purpose": "LOCATION",
            "city": "San Pedro",
            "state": "CA",
            "postal_code": "907323527",
            "country_code": "US",
            "telephone_number": "310-519-8890",
            "fax_number": "310-519-9349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUN",
        "first_name": "STACEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-30",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A160550",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "CA",
            "license": "A160550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4733 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nora Roisin Pulskamp
• Tariq Pulskamp, PHARMD
• Johannes Benjamin Pulst-Korenberg, MD
• Tessy Tatiana Pumaccahua, PH.D., LP
• Krystle M Pumarejo, LEP, MS, PPS
• Jaya Punati, MD
• Diksha Punia
• Stefani Punneli
• Celeste Punsal, FNP-C
• Gabriel Punsalan

• Dermatopathology (Pathology) Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dermatopathology (Pathology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; 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.