Individual provider Active NPI

Sung Yup Jung

  • Nurse Practitioner
  • Honolulu, HI
National Provider Identifier
1932537586
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1629 Issued in HI
Practice address
1520 Liliha St
Suite 601
Honolulu, HI 96817-3562
Phone
(808) 523-0445
Fax
(808) 523-0442
NPI assigned
Oct 17, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1629 HI Primary

Addresses

Primary practice location

1520 Liliha St
Suite 601
Honolulu, HI 96817-3562

Mailing address

1520 Liliha St
Suite 601
Honolulu, HI 96817-3562
Phone (808) 523-0445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140925002554 HI Practitioner - Nurse Practitioner 7517187586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1441 Kapiolani Blvd
Suite 706
Honolulu, HI 96814-4404
Phone (808) 781-8046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1629HIMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sung Yup Jung NP Inc Nurse Practitioner CurrentSince May 15, 2015 Accepting new patients
Rocky Mountain Kidney Care LLC PastSince Sep 15, 2024 Accepting new patients

Locations

1441 Kapiolani Blvd
Ste 706
Honolulu, HI 96814
Phone (808) 781-8046

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19427/brand/1/csg/1/fhir/r4
  • Direct secure messaging: sung.jung@95072532037636.direct.elationemr.com

Organizations & group practices 2

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": "1381968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444089600000",
    "number": "1932537586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 LILIHA ST",
            "address_2": "SUITE 601",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968173562",
            "telephone_number": "808-523-0445",
            "fax_number": "808-523-0442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 LILIHA ST",
            "address_2": "SUITE 601",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968173562",
            "telephone_number": "808-523-0445",
            "fax_number": "808-523-0442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "SUNG YUP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-17",
        "last_updated": "2015-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "HI",
            "license": "1629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.