Carrie Elizabeth Jung, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

128321 Issued in CA

Practice address

1200 N State St
Ipt C3F107
Los Angeles, CA 90033-1029

Phone

(323) 409-8848

NPI assigned

Jan 7, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Obstetrics/GynecologyAlso: Urology

Education

University of Miami, LM Miller School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Regents of the University of California

  • Obstetrics & Gynecology Physician
  • San Diego, CA
  • NPI 1174626618
  Medicare reassignment NPD
• Regents of the University of California

  • Plastic Surgery Physician
  • San Diego, CA
  • NPI 1326141862
  NPD
• Regents of the University of California

  • Anesthesiology Physician
  • San Diego, CA
  • NPI 1356444897
  NPD
• Regents of the University of California

  • Pulmonary Disease Physician
  • San Diego, CA
  • NPI 1386762300
  NPD
• Regents of the University of California

  • Allergy & Immunology Physician
  • San Diego, CA
  • NPI 1487772380
  NPD
• Regents of the University of California

  • Psychiatry Physician
  • San Diego, CA
  • NPI 1508968967
  NPD
• Regents of the University of California

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1558463927
  NPD
• Regents of the University of California

  • Family Medicine Physician
  • San Diego, CA
  • NPI 1578672184
  NPD
• Regents of the University of California

  • Neurology Physician
  • San Diego, CA
  • NPI 1649372673
  NPD
• Regents of the University of California

  • Ophthalmology Physician
  • San Diego, CA
  • NPI 1699877621
  NPD
• Regents of the University of California

  • Neurological Surgery Physician
  • San Diego, CA
  • NPI 1760594998
  NPD

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

{
    "created_epoch": "1389052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1922420199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "address_2": "IPT C3F107",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410",
            "telephone_number": "619-543-6164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "address_2": "IPT C3F107",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "323-409-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "CARRIE",
        "middle_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-07",
        "last_updated": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "128321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2425 Geary Blvd",
            "city": "San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jung Sun Lee
• Jung Yoon Chang Dental Corp
• Ae Young Jung
• Ariel Eunji Jung, MD
• Brennan Jung
• Chan Suk Jung
• Chanhwi Jung, L.AC
• Charles J. Jung, D.M.D.
• Christina Jung
• Christina Jung, MD, MPH

• Obstetrics & Gynecology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.