JUNG JOO MOON M.D., M.M.S
NPI 1083078315
General Practice in Atlanta, GA

Q: What is Jung Moon's NPI number?

The NPI number for Jung Moon is 1083078315. It was assigned to this individual provider in the NPPES registry on April 12, 2016.

Q: What is Jung Moon's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Q: When was this NPI record last updated?

The NPPES record for Jung Moon was last updated on June 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 April 12, 2016PECOS Enrolled

2875 LAKEWOOD AVE SW # A5, ATLANTA, GA 30315(713) 904-0106(862) 227-4081 Get Directions Write a Review

NPPES record last updated: June 16, 2026. Verified against the NPPES registry weekly; last sync: October 11, 2026.

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About Jung Joo Moon M.d., M.m.s NPPES

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

JUNG JOO MOON M.D., M.M.S (NPI 1083078315) is an individual general practice provider in Atlanta, Georgia, licensed in Georgia (90144) and active in the NPI registry since April 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1083078315

Entity TypeIndividualFemale

Primary Taxonomy208D00000X

Provider Legal NameJUNG JOO MOONCredential: M.D., M.M.S

Location Address2875 LAKEWOOD AVE SW # A5Atlanta, GA 30315-5801

Mailing Address2875 Lakewood Ave Sw Ste 1138Atlanta, GA 30315-5801 · (713) 904-0106 · Fax (862) 227-4081

Phone(713) 904-0106

Fax(862) 227-4081

Sole ProprietorNo

Enumeration DateApril 12, 2016

Last NPPES UpdateJune 16, 2026

NPPES CertifiedJune 16, 2026

✔ NPI 1083078315 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Licenses✔ Licensed in GA · 90144✔ Licensed in WI · 76451

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedPathology · Anatomic Pathology & Clinical PathologyTaxonomy 207ZP0102X · License 70750 (MN)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License 646517 (TX)

2875 LAKEWOOD AVE SW # A5, Atlanta, GA 30315

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jung Joo Moon M.d., M.m.s is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jung Moon's NPI number?

The NPI number for Jung Moon is 1083078315. It was assigned to this individual provider in the NPPES registry on April 12, 2016.

Where is Jung Moon located?

Jung Moon practices at 2875 Lakewood Ave SW # A5, Atlanta, GA 30315. The listed phone number is (713) 904-0106.

What is Jung Moon's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Jung Moon enrolled in Medicare?

Yes. Jung Moon is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jung Moon was last updated on June 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.