Jesse Jong-Shik Suh, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS016534 Issued in PA

Practice address

1601 Walnut St Ste 1128
Philadelphia, PA 19102-2913

Phone

(215) 207-9373

NPI assigned

May 21, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1922265404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 WALNUT ST STE 1128",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191022913",
            "telephone_number": "215-207-9373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WALNUT ST STE 1128",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191022913",
            "telephone_number": "215-207-9373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1166 Dekalb Pike Ste 109",
            "address_purpose": "LOCATION",
            "city": "Blue Bell",
            "state": "PA",
            "postal_code": "194221844",
            "country_code": "US",
            "telephone_number": "215-207-9373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUH",
        "first_name": "JESSE",
        "middle_name": "JONG-SHIK",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-21",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "68 017624",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francisco Felipe Suero, MD
• Britton Sugden, CRNA
• Masato Charles Sugeno, PHARMD
• Byungse Suh, MD
• Dong Hyun Suh
• Juwon Suh, RPH
• Moon Suh, D.O
• Mariam Suhaib
• Christopher Lee Suhr, O.D.
• Sabrina N Sukhan, MD

• Clinical Psychologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.