Individual provider Active NPI

Shawndeep S Tung, MD

  • Surgery Physician
  • Orange, CA
National Provider Identifier
1992077473
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A167229 Issued in CA
Practice address
230 S Main St Ste 100
Orange, CA 92868-3851
Phone
(714) 541-0101
Fax
(714) 541-0450
NPI assigned
Jan 31, 2012
Last updated
May 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A167229 CA Primary

Addresses

Primary practice location

230 S Main St Ste 100
Orange, CA 92868-3851

Mailing address

230 S Main St Ste 100
Orange, CA 92868-3851
Phone (714) 541-0101

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://fhir.memorialcare.org/fhir/api/FHIR/R4 Health Information Exchange (HIE) MemorialCare Medical Foundation
Direct Messaging Address stung673592@direct.memorialcare.org Direct MemorialCare Medical Foundation
FHIR URL https://memorialcare.org/fhir/api/FHIR/R4/ Health Information Exchange (HIE) MemorialCare Medical Foundation

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
I20200207002008 CA Practitioner - Surgical Oncology 1355695859 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Surgical Oncology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

230 S Main St
Suite 100
Orange, CA 92868-3851
Phone (714) 541-0101

24401 Health Ctr Dr
Suite 200
Laguna Hills, CA 92653-3651
Phone (657) 241-9660

722 Baker St
Costa Mesa, CA 92626-4320
Phone (714) 557-6300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.17 of 100Reported as group
Quality
81.15
Promoting interoperability
100
Improvement activities
40
Cost
71.64

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy25
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A167229CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Breastlink Medical Group Inc Surgery CurrentSince Feb 1, 2020 Accepting new patients
Memorialcare Medical Foundation Family Medicine CurrentSince Jan 1, 2021 Accepting new patients
Vicrumdeep S Tung MD Inc Surgery CurrentSince Oct 28, 2024 Accepting new patients
Bristol Park Medical Group, Inc Family Medicine Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Banner del E Webb Medical Center Past Accepting new patients
Banner Gateway Medical Center Past Accepting new patients
Beverly Radiology Medical Group Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

24401 Health Center Dr
Ste 200
Laguna Hills, CA 92653
Phone (657) 241-8788

230 S Main St
Ste 100
Orange, CA 92868
Phone (714) 541-0101

230 S Main St
Ste B100
Orange, CA 92868
Phone (714) 541-0101

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: stung673592@direct.memorialcare.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1327968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1992077473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 S MAIN ST STE 100",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683851",
            "telephone_number": "714-541-0101",
            "fax_number": "714-541-0450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 S MAIN ST STE 100",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683851",
            "telephone_number": "714-541-0101",
            "fax_number": "714-541-0450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUNG",
        "first_name": "SHAWNDEEP",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-31",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A167229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.memorialcare.org/fhir/api/FHIR/R4",
            "affiliation": "Y",
            "endpointDescription": "MemorialCare  FHIR Endpoint",
            "affiliationName": "MemorialCare Medical Foundation",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stung673592@direct.memorialcare.org",
            "affiliation": "Y",
            "endpointDescription": "Secure Email",
            "affiliationName": "MemorialCare Medical Foundation",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA/XML",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://memorialcare.org/fhir/api/FHIR/R4/",
            "affiliation": "Y",
            "endpointDescription": "MemorialCare FHIR Endpoint",
            "affiliationName": "MemorialCare Medical Foundation",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.