BONG SOO EUN PHD
NPI 1124275664
Psychologist in Richmond, VA
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
Specialties & Licenses
Other Identifiers 1
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).
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.
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.
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.