Individual provider Active NPI

Jinsoo Andrew Keyoung, MD

  • Body Imaging Physician
  • Stanford, CA
National Provider Identifier
1962501833
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Body Imaging PhysicianTaxonomy code 2085B0100X
License
A84087 Issued in CA
Practice address
300 Pasteur Dr
Stanford, CA 94305-2200
Phone
(650) 723-4000
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A84087 CA
Body Imaging Physician 2085B0100X A84087 CA Primary

Addresses

Primary practice location

300 Pasteur Dr
Stanford, CA 94305-2200

Mailing address

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

Other practice location 1

One Hoag Drive
Newport Beach, CA 92663-4162
Phone (949) 645-3534

Other practice location 2

Dept LA 21555
Pasadena, CA 91185-1555
Phone (949) 263-8620

Other identifiers 2

IdentifierTypeStateIssuer
00A840870OtherCABS
00A840870MedicaidCA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20061024000265 CA Practitioner - Diagnostic RadiologyPractitioner - Other (Physician) 1759388341 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Georgetown University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Newport Harbor Radiology Associates Medical Group IncGroup PAC ID 1850285735, 69 clinicians
Stanford Health CareGroup PAC ID 6709797491, 3,152 clinicians
Newport Center Radiology Associates Medical Group IncGroup PAC ID 7810800166, 60 clinicians

Practice addresses (Care Compare)

1 Hoag Dr
Newport Beach, CA 92663-4162
Phone (949) 645-3534

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

360 San Miguel Dr
Suite 105And106
Newport Beach, CA 92660-7853
Phone (949) 365-3534

Hospital & facility affiliations

  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224
  • Hoag Orthopedic Institute Hospital, Irvine, CA, CCN 050769
  • Stanford Health Care Hospital, Stanford, CA, CCN 050441
  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567
  • Usc Kenneth Norris Jr Cancer Hospital Hospital, Los Angeles, CA, CCN 050660

Merit-based Incentive Payment System (MIPS)

Final score
95.45 of 100Reported as group
Quality
100
Improvement activities
40
Cost
84.82

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
87.08
Promoting interoperability
100
Improvement activities
40
Cost
69.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A84087CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newport Harbor Radiology Associates Medical Group, Inc Diagnostic Radiology CurrentSince Nov 17, 2017 Accepting new patients
Stanford Health Care Diagnostic Radiology Current Accepting new patients
Stanford Health Care Diagnostic Radiology CurrentSince Aug 17, 2021 Accepting new patients
Stanford Health Care CurrentSince Aug 17, 2021 Accepting new patients
LPCH Medical Group Div of Lucile CurrentSince Aug 17, 2021 Accepting new patients
Newport Center Radiology Associates Medical Group Inc Diagnostic Radiology CurrentSince Nov 17, 2017 Accepting new patients
Newport Center Radiology Medical Group Inc. Past Accepting new patients
Lucile Salter Packard Children'S Hospital at Stanford Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients

Locations

16250 Sand Canyon Ave
Irvine, CA 92618
Phone (855) 999-4641

16200 Sand Canyon Ave
Irvine, CA 92618
Phone (949) 753-2000

18301 Von Karman Ave
Ste 310
Irvine, CA 92612
Phone (949) 645-3534

7999 Gateway Blvd
Ste 200
Newark, CA 94560
Phone (510) 806-2947

1 Hoag Dr
Newport Beach, CA 92663
Phone (877) 742-4624

455 Old Newport Blvd
Ste 101
Newport Beach, CA 92663
Phone (949) 574-8200

360 San Miguel Dr
Ste 1
Newport Beach, CA 92660
Phone (949) 365-3534

360 San Miguel Dr
Ste 105106
Newport Beach, CA 92660

360 San Miguel Dr
Ste 105
Newport Beach, CA 92660
Phone (949) 365-3534

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

Dept LA 21705
Pasadena, CA 91185

Dept LA 21555
Pasadena, CA 91185
Phone (949) 236-8620

300 Pasteur Dr
#5500
Stanford, CA 94305
Phone (415) 723-5525

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Organizations & group practices 9

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1962501833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "One Hoag Drive",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "926634162",
            "country_code": "US",
            "telephone_number": "949-645-3534",
            "fax_number": "949-645-3693",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Dept LA 21555",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911851555",
            "country_code": "US",
            "telephone_number": "949-263-8620",
            "fax_number": "949-263-1639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEYOUNG",
        "first_name": "JINSOO",
        "middle_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A84087",
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "CA",
            "license": "A84087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "00A840870",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A840870",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.