Individual provider Active NPI

Peter Jung, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Seattle, WA
National Provider Identifier
1932542792
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
MD61127837 Issued in WA
Practice address
3626 NE 45TH St Ste 300
Seattle, WA 98105-5653
Phone
(206) 526-2600
NPI assigned
Apr 11, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Neonatal-Perinatal Medicine Physician 2080N0001X MD61127837 WA Primary

Addresses

Primary practice location

3626 NE 45TH St Ste 300
Seattle, WA 98105-5653

Mailing address

3626 NE 45TH St Ste 300
Seattle, WA 98105-5653
Phone (206) 526-2600

Other practice location 1

11234 Anderson St
Loma Linda, CA 92354-2804
Phone (909) 558-4174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20240318002808 WA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 7719242684

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61127837WAMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Edmonds Past Accepting new patients
Overlake Medical Center & Clinics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: pjung62322@direct.llu.edu

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": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1932542792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3626 NE 45TH ST STE 300",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981055653",
            "telephone_number": "206-526-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3626 NE 45TH ST STE 300",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981055653",
            "telephone_number": "206-526-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11234 Anderson St",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542804",
            "country_code": "US",
            "telephone_number": "909-558-4174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUNG",
        "first_name": "PETER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-11",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "WA",
            "license": "MD61127837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.