Individual provider Active NPI

Seung J Yo, MD

  • Diagnostic Radiology Physician
  • Reston, VA
National Provider Identifier
1922025618
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0101225839 Issued in VA
Practice address
11445 Sunset Hills Rd
Reston, VA 20190-5276
Phone
(703) 709-1500
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD039182 DC
Diagnostic Radiology Physician 2085R0202X 0101225839 VA Primary
Diagnostic Radiology Physician 2085R0202X D0060078 MD

Addresses

Primary practice location

11445 Sunset Hills Rd
Reston, VA 20190-5276

Mailing address

2101 E Jefferson St
Kaiser Permanente Medicare Enrollment
Rockville, MD 20852-4908
Phone (301) 816-2424

Other identifiers 3

IdentifierTypeStateIssuer
60234801OtherMDBLUE SHIELD
405175100MedicaidMD
80430037OtherDCBLUE SHIELD

Electronic endpoints 2

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE) Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD, VA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20040901001400 DC Practitioner - Diagnostic Radiology 0941275879 Reassigns benefits to 1 organization
I20080806000223 MD Practitioner - Diagnostic Radiology 0941275879 Reassigns benefits to 1 organization
I20111013000302 VA Practitioner - Diagnostic Radiology 0941275879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Virginia Commonwealth University, School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, shared by 17 NPIs, 1,921 clinicians

Practice addresses (Care Compare)

10810 Connecticut Ave
Kensington, MD 20895-2138
Phone (301) 929-7100

1201 Hospital Dr
Fredericksburg, VA 22401-8428
Phone (540) 368-3700

1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700

12255 Fair Lakes Pkwy
Fairfax, VA 22033-3952
Phone (703) 237-4800

125 Hospital Ctr Blvd
Stafford, VA 22554-6202
Phone (540) 602-6500

13285 Minnieville Rd
Woodbridge, VA 22192-4018
Phone (703) 986-2400

14139 Potomac Mills Rd
Woodbridge, VA 22192-4644
Phone (703) 257-3000

1890 Metro Ctr Dr
Reston, VA 20190-5286
Phone (703) 709-1500

201 N Washington St
Falls Church, VA 22046-4518
Phone (703) 237-4000

5100 Auth Way
Suitland, MD 20746-4207
Phone (301) 702-5000

5620 Ager Rd
Hyattsville, MD 20782-3729
Phone (240) 906-6600

6104 Old Branch Ave
Temple Hills, MD 20748-2518
Phone (301) 702-6100

655 Watkins Mill Rd
Gaithersburg, MD 20879-3301
Phone (240) 632-4000

6551 Loisdale CT
Springfield, VA 22150-1828
Phone (703) 922-1000

7141 Security Blvd
Woodlawn Med Ctr
Baltimore, MD 21244-1811
Phone (443) 663-6000

8008 Westpark Dr
MC Lean, VA 22102-3109
Phone (703) 287-6400

Kaiser Permanente-Haymarket Cross Rd
15050 Healthcote Blvd
Haymarket, VA 20169-6251
Phone (571) 445-7200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD039182DCMDDiagnostic Radiology Physician
D0060078MDMDDiagnostic Radiology Physician
0101225839VAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Diagnostic Radiology CurrentSince Jul 9, 2011 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Diagnostic Radiology CurrentSince May 27, 2012 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Diagnostic Radiology CurrentSince Dec 22, 2010 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Dec 22, 2010 Accepting new patients
Clinical Imaging of Silver Spring LLC Diagnostic Radiology Past Accepting new patients
Diagnostic Medical Imaging PA Diagnostic Radiology PastSince Oct 24, 2021 Accepting new patients
American Radiology Associates, P.a. Diagnostic Radiology Past Accepting new patients
American Radiology Associates, P.a. Diagnostic Radiology Past Accepting new patients
Clinical Radiologists Medical Imaging PA Diagnostic Radiology Past Accepting new patients

Locations

7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600

7190 Crestwood Blvd
Frederick, MD 21703
Phone (240) 529-1700

2101 E Jefferson St
Ste 6
Rockville, MD 20852

2101 E Jefferson St
Ste 4EAST
Rockville, MD 20852

2101 E Jefferson St
#4E
Rockville, MD 20852

2101 E Jefferson St
Ste 6W
Rockville, MD 20852
Phone (301) 816-5853

2101 E Jefferson St
Rockville, MD 20852
Phone (301) 816-6660

6701 N Charles St
Towson, MD 21204
Phone (443) 849-2000

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

7141 Security Blvd
Windsor Mill, MD 21244
Phone (410) 281-6200

1890 Metro Center Dr
Reston, VA 20190
Phone (703) 709-1500

14139 Potomac Mills Rd
Woodbridge, VA 22192
Phone (703) 257-3000

Organizations & group practices 9

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1922025618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 E JEFFERSON ST",
            "address_2": "KAISER PERMANENTE MEDICARE ENROLLMENT",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524908",
            "telephone_number": "301-816-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11445 SUNSET HILLS RD",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905276",
            "telephone_number": "703-709-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YO",
        "first_name": "SEUNG",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "DC",
            "license": "MD039182",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101225839",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D0060078",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "60234801",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405175100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "80430037",
            "state": "DC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "c-cda",
            "address_1": "11445 Sunset Hills Rd",
            "city": "Reston",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201905276",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2400 Mount Zion Pkwy",
            "city": "Jonesboro",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302362500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.