Jeanie Hee-Kyung Chung, M.D., PHD
Individual provider Active NPI Dermatology Physician · Salida, CO
NPI 1962582817 · NPPES record last updated Feb 23, 2023
Key facts
- NPI
- 1962582817
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- CDRH.0038765 (CO)
- Practice address
- 925 Rush Dr
Salida, CO 81201-9665 - Phone
- (719) 539-4600
- Fax
- (719) 539-4629
- NPI assigned
- Oct 16, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Dermatology
- Education
- JS Weill Medical College, Cornell University, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bella Derma, LLC
Practice addresses (Care Compare)
261 Robinson St
Suite C100
Basalt, CO 81621-8387
Phone (970) 927-2800
925 Rush Dr
Salida, CO 81201-9665
Phone (719) 539-4600
Hospital & facility affiliations
- Heart of the Rockies Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.01 of 100
- Quality
- 100
- Improvement activities
- 40
- Cost
- 83.36
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 51 |
| Removal of skin lesions | 543 |
| Removal of skin cancer | 98 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 132 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041220000461 | CO | Practitioner - Dermatology | 1951299775 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38765 | CO | MD | Specialist |
| CDRH.0038765 | CO | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bella Derma, LLC | Dermatology | Current |
Accepting new patients |
| Boulder Valley Center for Dermatology LLC | Dermatology | Past |
Accepting new patients |
Locations
261 Robinson St
Ste C100
Basalt, CO 81621
Phone (970) 927-2800
925 Rush Dr
Salida, CO 81201
Phone (719) 539-4600
7300 Ranch Road 2222
Bldg 1
Austin, TX 78730
Interoperability endpoints
- https://api.platform.athenahealth.com/2831/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 38765 | CO | |
| Dermatology Physician | 207N00000X | CDRH.0038765 | CO | Yes |
Addresses
Primary practice location
925 Rush Dr
Salida, CO 81201-9665
Mailing address
7300 Ranch Road 2222, Building 1, Ste 200
Austin, TX 78730
Phone (512) 628-0465
Other practice location 1
1140 W South Boulder Rd
Suite 202
Lafayette, CO 80026-8910
Phone (303) 604-1444
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 014977 | Other | CO | KAISER COMMERCIAL NUMBER |
| 82157227 | Medicaid | CO |
Other names
- Hee Kyung Leddon
Other providers in Salida, CO
- Gretchen Lynette Chamberlain
- Mardi L Chambers
- Nicholas Jordan Chariton
- Chimera Counseling PLLC
- Chipita Counseling Services LLC
- Robert Joseph Clark II
- Cindy Anne Cleary
- Whitney K Cline
- Cloud 9 Chiropractic and Day Spa
- Coalescence Health PLLC
All providers in Salida, CO · Dermatology Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.