BONG SOO EUN PHD
NPI 1124275664
Psychologist in Richmond, VA

Active since August 27, 2008PECOS Enrolled
9702 GAYTON RD, #181, RICHMOND, VA 23238(804) 741-7500(804) 741-7900 Get Directions Write a Review

NPPES record last updated: August 27, 2008. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Bong Soo Eun Phd NPPES

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

BONG SOO EUN PHD (NPI 1124275664) is an individual psychologist in Richmond, Virginia, licensed in Virginia (0810001902) and active in the NPI registry since August 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124275664
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameBONG SOO EUNCredential: PHD
Location Address9702 GAYTON RD, #181Richmond, VA 23238-4907
Mailing Address9702 Gayton Rd, #181Richmond, VA 23238-4907 · (804) 741-7500 · Fax (804) 741-7900
Fax(804) 741-7900
Sole ProprietorNo
Enumeration DateAugust 27, 2008
✔ NPI 1124275664 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in VA · 0810001902
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
9702 GAYTON RD, Richmond, VA 23238

Other Identifiers 1

Other0810001902VA · Virginia State Medical License

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bong Soo Eun Phd 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.

Medicare Billing Reassignment

Medicare enrollment records show Bong Soo Eun reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Clinical
7272 WURZBACH RD, SUITE 601
San Antonio, TX 78240
  • Reassigned Medicare billing, Virginia enrollment
  • 29 clinicians in this Medicare group

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

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.

Social Worker (Clinical)
9702 GAYTON RD, #181
RICHMOND, VA 23238
Psychologist (Clinical)
9702 GAYTON RD, #181
RICHMOND, VA 23238
Social Worker (Clinical)
9702 GAYTON RD, #181
RICHMOND, VA 23238
Psychologist (Clinical)
9702 GAYTON RD, #181
RICHMOND, VA 23238
Social Worker (Clinical)
9702 GAYTON RD, #181
RICHMOND, VA 23238
Psychologist (Clinical)
9702 GAYTON RD, #181
RICHMOND, VA 23238
Social Worker (Clinical)
9702 GAYTON RD, #181
RICHMOND, VA 23238
Psychologist (Clinical)
9702 GAYTON RD, #181
RICHMOND, VA 23238

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 Bong Soo Eun's NPI number?

The NPI number for Bong Soo Eun is 1124275664. It was assigned to this individual provider in the NPPES registry on August 27, 2008.

Where is Bong Soo Eun located?

Bong Soo Eun practices at 9702 Gayton Rd #181, Richmond, VA 23238. The listed phone number is (804) 741-7500.

What is Bong Soo Eun's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Bong Soo Eun enrolled in Medicare?

Yes. Bong Soo Eun is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Bong Soo Eun's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Bong Soo Eun reassigns Medicare benefits to Deer Oaks Southeast LLC (San Antonio, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Bong Soo Eun's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Bong Soo Eun was last updated on August 27, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.