NPIMap

Individual provider Active NPI

Jung H Joh, MD

  • Nephrology Physician
  • Shoreline, WA
National Provider Identifier
1891770533
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD00036853 Issued in WA
Practice address
1130 N 185TH St Ste 201
Shoreline, WA 98133-4011
Phone
(206) 542-1000
Fax
(206) 542-5353
NPI assigned
Dec 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD00036853 WA Primary

Addresses

Primary practice location

1130 N 185TH St Ste 201
Shoreline, WA 98133-4011

Mailing address

1130 N 185TH St Ste 201
Shoreline, WA 98133-4011
Phone (206) 542-1000

Other identifiers 1

IdentifierTypeStateIssuer
8238495MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041013000603 WA Practitioner - NephrologyPractitioner - Internal Medicine 5092605964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Seattle Nephrology PLLCGroup PAC ID 9830089705, 3 clinicians

Practice addresses (Care Compare)

1130 N 185TH St
Suite 201
Shoreline, WA 98133-4011
Phone 2065421000109

Hospital & facility affiliations

  • Puget Sound KC South Dialysis facility, Mountlake Terrace, WA, CCN 502521
  • NKC Lake City Kidney Center Dialysis facility, Lake Forest Park, WA, CCN 502536
  • NKC Scribner Kidney Center Dialysis facility, Seattle, WA, CCN 502507
  • PSKC-Richmond Beach Dialysis facility, Shoreline, WA, CCN 502618
  • Swedish Edmonds Hospital Hospital, Edmonds, WA, CCN 500026
  • University of Washington Medical Ctr Hospital, Seattle, WA, CCN 500008
  • Swedish Medical Center Hospital, Seattle, WA, CCN 500027
  • Evergreenhealth Medical Center Hospital, Kirkland, WA, CCN 500124

Merit-based Incentive Payment System (MIPS)

Final score
69.65 of 100Reported as individual
Quality
15
Improvement activities
40
Cost
84.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00036853WAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Endocrinology Inc Past Accepting new patients
Northwest Inpatient Services Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: seattlenephrology.jungjoh@118869.advancedmd-direct.com

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.

Hospital & facility affiliations 8

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": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1891770533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 N 185TH ST STE 201",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981334011",
            "telephone_number": "206-542-1000",
            "fax_number": "206-542-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 N 185TH ST STE 201",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981334011",
            "telephone_number": "206-542-1000",
            "fax_number": "206-542-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOH",
        "first_name": "JUNG",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "MD00036853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8238495",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

Verify at the official NPI Registry.