Tae-Woong Im, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G72383 Issued in CA

Practice address

28780 Single Oak Dr
Suite 160
Temecula, CA 92590-5528

Phone

(951) 676-4193

Fax

(951) 719-1469

NPI assigned

May 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Family Practice

Education

Loma Linda University School of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rancho Family Medical Group IncGroup PAC ID 6305741240, 112 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: tim181959@direct.llu.edu

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.

• Rancho Family Medical Group, Inc.

  • Family Medicine Physician
  • Temecula, CA
  • NPI 1598791600
  Medicare reassignment Care Compare group NPD
• Physicians' Hospital of Murrieta, LLC

  • General Acute Care Hospital
  • Murrieta, CA
  • NPI 1386945947
  NPD (past)
• Regents of the University of California

  • Pharmacy
  • San Diego, CA
  • NPI 1598786576
  NPD (past)
• Temecula Valley Hospital Inc

  • General Acute Care Hospital
  • Temecula, CA
  • NPI 1679816201
  NPD (past)
• UC San Diego Health - Rancho Family Medical Group

  • Multi-Specialty Clinic/Center
  • Temecula, CA
  • NPI 1003385071
  NPD (past)
• Universal Health Services of Rancho Springs Inc

  • General Acute Care Hospital
  • Murrieta, CA
  • NPI 1245221050
  NPD (past)

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1912956855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28780 SINGLE OAK DR",
            "address_2": "SUITE 160",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925905528",
            "telephone_number": "951-676-4193",
            "fax_number": "951-719-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28780 SINGLE OAK DR",
            "address_2": "SUITE 160",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925905528",
            "telephone_number": "951-676-4193",
            "fax_number": "951-719-1469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IM",
        "first_name": "TAE-WOONG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G72383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idocs Optometry, Inc.
• Metzly Igualate
• Udoka Odumbu Ikezuagu, MD
• Hannah Ilges
• Helen H. Im, DDS
• Imani Woundcare Services Inc
• Imani Woundcare Services Inc
• Wesley Imayanagita, LCSW
• Janelle Marie Imber, FNP
• Independent Anesthesia Consultants of Riverside a Medical Corporation

• Family Medicine Physician in Temecula, CA
• Providers in Temecula, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; 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.