DR. YOUNGSIK MOON (NPI# 1245263193) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245263193 |
| Entity Type | Individual |
| Full Name | DR. YOUNGSIK MOON |
| Credential | M.D. |
| Practice Address |
24435 Mervell Dean Rd Hollywood MD 20636-2712 |
| Mailing Address |
Po Box 37 Hollywood MD 20636-0037 |
| Practice Telephone | 3013732116 |
| Practice Fax Number | 3013735281 |
| Mailing Telephone | 3013732116 |
| Mailing Fax Number | 3013735281 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | D09178 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FIRST HEALTH/CCN | 886111 | 01 | |
| AETNA | 4509253 | 01 | |
| AMERIGROUP | 52183-01 | 01 | |
| UNITED HEALTHCARE PCP | 1092689 | 01 | |
| MD | CAREFIRST BCBS | 39934701 | 01 |
| UNITED HEALTHCARE SPECIAL | 182572 | 01 | |
| MAMSI | 418489 | 01 | |
| TRICARE | 521001342002 | 01 | |
| DC | CAREFIRST BCBS OF DC | 13070001 | 01 |
| MAMSI | 218489 | 01 | |
| CIGNA | 3258989002 | 01 | |
| AMERIGROUP | 52183-03 | 01 | |
| AETNA HMO | 546386 | 01 |
| 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 |
| 1245447465 | Youngsik Moon, M.d., P.a. | General Practice | 24435 Mervell Dean Rd, Hollywood, MD 20636-2712 | 2007-05-17 |
| 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 |
| 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 | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649834169 | Florida Comprehensive Health Management LLC | Surgery | 3475 Sheridan St Ste 101, Hollywood, FL 33021-3633 | 2019-04-30 |
| 1376965459 | Ira Glazer | Surgery | 524 N Rainbow Dr, Hollywood, FL 33021-6060 | 2014-01-09 |
| 1780954859 | Michael Parmer | Surgery | 2301 S Ocean Dr, Apt. 504, Hollywood, FL 33019-2621 | 2012-01-06 |
| 1477874907 | Courtney Michelle Edwards | Surgery | 1150 N 35th Ave Ste 200, Hollywood, FL 33021 | 2010-06-18 |
| 1710178116 | Narciso Lino Gomez | Surgery | 3475 Sheridan St Ste 201, Hollywood, FL 33021-3659 | 2007-08-09 |
| 1932319076 | Yin-kan Hwee | Surgery | 1201 N 35th Ave, Suite 200, Hollywood, FL 33021-5468 | 2007-05-23 |
| 1821002171 | Alexander Marmureanu | Surgery | 6253 Hollywood Blvd Apt 1108, Hollywood, CA 90028-8261 | 2006-07-29 |
| 1477567642 | Michael J Mallis | Surgery | 4651 Sheridan St Ste 350, Hollywood, FL 33021-3425 | 2006-07-27 |
| 1760400030 | Robert B Donoway | Surgery | 4000 Hollywood Blvd, Presidential Circle, Suite 160 North, Hollywood, FL 33021-6751 | 2006-07-17 |
| 1770540494 | Luis Asanza | Surgery | 4811 Hollywood Blvd, Suite C, Hollywood, FL 33021 | 2006-04-27 |
| 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.