Individual provider Active NPI

Timothy Youngkyun Woo, DC

  • Chiropractor
  • San Carlos, CA
National Provider Identifier
1962025437
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC34689 Issued in CA
Practice address
1100 Laurel St Ste D
San Carlos, CA 94070-5000
Phone
(650) 226-8348
Fax
(650) 666-6747
NPI assigned
May 19, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC34689 CA Primary

Addresses

Primary practice location

1100 Laurel St Ste D
San Carlos, CA 94070-5000

Mailing address

1100 Laurel St Ste D
San Carlos, CA 94070-5000
Phone (650) 226-8348

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1122 Corporate Way
Suite 300
Sacramento, CA 95831-6125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC34689CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Perfectly Aligned Wellness, a Nissenbaum Chiropractic PC Chiropractor CurrentSince Apr 6, 2021 Accepting new patients
Dr. Scott Nissenbaum Chiropractic LLC CurrentSince May 24, 2020 Accepting new patients

Locations

1100 Laurel St
Ste D
San Carlos, CA 94070
Phone (650) 226-8348

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": "1589846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1962025437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 LAUREL ST STE D",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940705000",
            "telephone_number": "650-226-8348",
            "fax_number": "650-666-6747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LAUREL ST STE D",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940705000",
            "telephone_number": "650-226-8348",
            "fax_number": "650-666-6747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOO",
        "first_name": "TIMOTHY",
        "middle_name": "YOUNGKYUN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-19",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC34689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Carlos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.