YOUNGSIK MOON, M.D., P.A. (NPI# 1245447465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245447465 |
| Entity Type | Organization |
| Organization Name | YOUNGSIK MOON, M.D., P.A. |
| Other Organization Name | HOLLYWOOD MEDICAL CENTER |
| Practice Address |
24435 Mervell Dean Rd Hollywood MD 20636-2712 |
| Mailing Address |
24435 Mervell Dean Rd Po Box 37 Hollywood MD 20636-2712 |
| Practice Telephone | 3013732116 |
| Practice Fax Number | 3013735281 |
| Mailing Telephone | 3013732116 |
| Mailing Fax Number | 3013735281 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2011-03-24 |
| Authorized Official Name | MS. BETTY ANN QUADE (BUSINESS MANAGER) |
| Authorized Official Telephone | 3013732116 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | D09178 | MD | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | D09178 | MD | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CIGNA | 2120400 | 01 | |
| MD | 531541700 | 05 | |
| AETNA HMO | 1010188 | 01 | |
| MD | AMERIGROUP | 112048 | 01 |
| MAMSI | 818489 | 01 | |
| MD | RAILRAOD MEDICARE | DG3783 | 01 |
| OWCP | 145464300 | 01 | |
| AETNA PPO | 5972624 | 01 | |
| DC | CAREFIRST BCBS OF DC | 1307 | 01 |
| MD | CAREFIRST BCBS OF MD | KQ75 | 01 |
| Other Name | Type Code |
|---|---|
| Hollywood Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831203215 | Youngsik Moon, M.d., P.a. | Clinic/Center | 24435 Mervell Dean Rd, Hollywood, MD 20636-2712 | 2006-08-19 |
| Street Address |
24435 MERVELL DEAN RD |
| City | HOLLYWOOD |
| State | MD |
| Zip Code | 20636-2712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972591345 | Kenneth Taedo Moon | Family Medicine | 24435 Mervell Dean Rd, Hollywood, MD 20636-2712 | 2005-10-11 |
| 1912360181 | Michelle Munson | Nurse Practitioner | 24435 Mervell Dean Rd, Hollywood, MD 20636-2712 | 2016-04-04 |
| 1821331539 | Laura Zilberman | Nurse Practitioner | 24435 Mervell Dean Rd, Hollywood, MD 20636-2712 | 2013-04-01 |
| 1679710776 | Leena Kosandal | Family Medicine | 24435 Mervell Dean Rd, Hollywood, MD 20636-2712 | 2009-01-12 |
| 1831203215 | Youngsik Moon, M.d., P.a. | Clinic/Center | 24435 Mervell Dean Rd, Hollywood, MD 20636-2712 | 2006-08-19 |
| 1124051099 | Kimberly E Cook | Nurse Practitioner | 24435 Mervell Dean Rd, Hollywood, MD 20636-2712 | 2006-07-07 |
| 1245263193 | Youngsik Moon | Surgery | 24435 Mervell Dean Rd, Hollywood, MD 20636-2712 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841708427 | Lisa Early | Case Manager/Care Coordinator | 24077 John Cameron Way, Hollywood, MD 20636 | 2018-01-17 |
| 1326439365 | Maryland Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 24288 Three Notch Rd., Hollywood, MD 20636 | 2015-02-12 |
| 1972810612 | Kathleen Latona Boyles | Pharmacist | 24288 Three Notch Road, Hollywood, MD 20636 | 2010-09-01 |
| 1386825271 | Vijaya Guduri | Internal Medicine | 24035 Three Notch Road, Shah Associates Md LLC, Hollywood, MD 20636 | 2007-11-19 |
| 1245397678 | St Johns Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 24288 Three Notch Rd, Hollywood, MD 20636 | 2007-01-03 |
| 1194824755 | Julie Wilkening | Chiropractor | 24351 Mervell Dean Rd #115, Hollywood, MD 20636 | 2006-09-21 |
| 1225134281 | Mary Rice Hughes | Registered Nurse | 44101 Airport View Dr., Hollywood, MD 20636 | 2006-09-16 |
| 1376654194 | Suzanne Janis Pelz | Counselor | 44101 Airport View Drive, Hollywood, MD 20636 | 2006-08-31 |
| 1831406883 | Hanna Kristina Dennis | Physician Assistant | 24035 Three Notch Rd, Hollywood, MD 20636 | 2010-09-10 |
| 1750549010 | Iram A Khan | Internal Medicine | 24035 Three Notch Road, Hollywood, MD 20636 | 2008-05-22 |
| Find all providers in zip 20636 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336752088 | Christy Nicole Johnson | Family Medicine | 634 Drew Dr, Hollywood, AL 35752-6556 | 2020-08-24 |
| 1669931762 | Premier Healthcare Centers, LLC | Family Medicine | 9950 Stirling Rd Ste 108, Hollywood, FL 33024-8001 | 2019-03-18 |
| 1689026460 | Sanrol Medical Center Inc | Family Medicine | 7160 Stirling Rd, Hollywood, FL 33024-1650 | 2016-07-06 |
| 1366896904 | South Florida Family Medical Center, LLC. | Family Medicine | 7369 Sheridan St Ste 100, Hollywood, FL 33024 | 2016-04-20 |
| 1790032530 | Kyle Petersen | Family Medicine | 3157 N University Dr Ste 101, Hollywood, FL 33024-2258 | 2012-08-10 |
| 1184989139 | Evgeny Goldman | Family Medicine | 6100 Hollywood Blvd Ste 300, Hollywood, FL 33024-7982 | 2012-07-05 |
| 1699047654 | Gg Healthcare Pa | Family Medicine | 6241 Pembroke Rd, Hollywood, FL 33023-2215 | 2012-02-06 |
| 1285932947 | Frank C Alario Md Pl | Family Medicine | 5700 Stirling Rd Ste 100, Hollywood, FL 33021-1522 | 2011-03-04 |
| 1982835559 | Maria Strimbu | Family Medicine | 4030 Sheridan St Ste A, Hollywood, FL 33021-3564 | 2009-07-30 |
| 1396998944 | Wilson Izquierdo | Family Medicine | 2229 Sheridan St, Hollywood, FL 33020-2040 | 2008-10-28 |
| Find all providers in HOLLYWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.