SE JIN AHN M.D.
NPI 1083020820
Radiology - Diagnostic Radiology in Dallas, TX

Q: What is Se Jin Ahn's NPI number?

The NPI number for Se Jin Ahn is 1083020820. It was assigned to this individual provider in the NPPES registry on July 1, 2014.

Q: What is Se Jin Ahn's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Q: When was this NPI record last updated?

The NPPES record for Se Jin Ahn was last updated on April 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 01, 2014PECOS EnrolledAccepts Medicare Assignment

2825 OAK LAWN AVE UNIT 192749, DALLAS, TX 75219(510) 683-9500 Get Directions Write a Review

NPPES record last updated: April 3, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 3, 2026, Oct 21, 2019, Jul 26, 2019 (3 updates tracked since 2019).

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About Se Jin Ahn M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SE JIN AHN M.D. (NPI 1083020820) is an individual diagnostic radiology provider in Dallas, Texas, licensed in Washington (MD61036239) and active in the NPI registry since July 2014. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1083020820

Entity TypeIndividualFemale

Primary Taxonomy2085R0202X

Provider Legal NameSE JIN AHNCredential: M.D.

Location Address2825 OAK LAWN AVE UNIT 192749Dallas, TX 75219-4688

Mailing Address2825 Oak Lawn Ave Unit 192749Dallas, TX 75219-4688 · (510) 683-9500 · Fax (877) 880-2039

Phone(510) 683-9500

Sole ProprietorYes

Medical School CMSOtherGraduated 2008

Enumeration DateJuly 1, 2014

Last NPPES UpdateApril 3, 20263 updates tracked since enumeration

NPPES CertifiedApril 3, 2026

✔ NPI 1083020820 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

Licenses✔ Licensed in WA · MD61036239✔ Licensed in CA · A159414✔ Licensed in OH · 35C.003922✔ Licensed in TX · T7407

Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

2825 OAK LAWN AVE UNIT 192749, Dallas, TX 75219

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Secondary Practice Locations 2

Location 1757 Westwood Plz Ste 1638Los Angeles, CA 90095-5201 · Phone (310) 267-8796 · Fax (310) 267-2059

Location 21245 16th St Ste 105Santa Monica, CA 90404-1239 · Phone (310) 301-6800 · Fax (310) 794-9035

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Se Jin Ahn M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8527394865

PECOS Enrollment IDI20200810003482

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Se Jin Ahn reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Osu Radiology LLC

913 mi

Diagnostic Radiology

520 W 10TH AVE
Columbus, OH 43210

Reassigned Medicare billing, Washington enrollment
3 clinicians in this Medicare group

NPI 1912956814 (614) 293-8315

Sutter Valley Medical Foundation

1,080 mi

Diagnostic Radiology

2995 AMERICAN RIVER LN
Las Vegas, NV 89135

Reassigned Medicare billing, Washington enrollment
3 clinicians in this Medicare group

NPI 1174997407 (209) 521-6097

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75219 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.19 typical visit price

range $57.18 – $172.86

Typical copayment $22.04 (range $14.29 – $43.21)

Most-billed visit code 99203

Established Patient

$71.28 typical visit price

range $18.48 – $141.20

Typical copayment $17.82 (range $4.62 – $35.30)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AJLA KADRIBEGIC MD

Radiology (Diagnostic Radiology)