Individual provider Active NPI

Jack Choi, MD

  • Family Medicine Physician
  • Burien, WA
National Provider Identifier
1902840382
Registry record updated Jun 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00039615 Issued in WA
Practice address
322 SW 155TH St Ste C
Burien, WA 98166-2590
Phone
(206) 453-4215
Fax
(206) 453-4234
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00039615 WA Primary

Addresses

Primary practice location

322 SW 155TH St Ste C
Burien, WA 98166-2590

Mailing address

322 SW 155TH St Ste C
Burien, WA 98166-2590
Phone (206) 453-4215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20040528000282 WA Practitioner - Family Practice 5294716833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

322 SW 155TH St
Suite C
Burien, WA 98166-2590
Phone (206) 948-6141

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00039615WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Home Towne Family Medicine PLLC Family Medicine CurrentSince Aug 18, 2008 Accepting new patients
Highline Medical Group Inc Family Medicine Past Accepting new patients
Pacific Prosthetics and Orthotics, LLC PastSince Aug 18, 2008 Accepting new patients

Locations

322 SW 155th St
Ste C
Burien, WA 98166
Phone (206) 453-4215

15580 3rd Ave SW
Ste 101
Burien, WA 98166
Phone (206) 453-4215

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 4

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685836800000",
    "number": "1902840382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 SW 155TH ST STE C",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981662590",
            "telephone_number": "206-453-4215",
            "fax_number": "206-453-4234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 SW 155TH ST STE C",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981662590",
            "telephone_number": "206-453-4215",
            "fax_number": "206-453-4234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "JACK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2023-06-04",
        "certification_date": "2023-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00039615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burien, WA

Sources for this page

Verify at the official NPI Registry.