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JACKY KIM CHUN PA-C
NPI 1164140109
Physician Assistant - Medical in Rockville, MD

Active since August 16, 2022PECOS EnrolledAccepts Medicare Assignment
86.79/100
CMS Quality Rating
15001 SHADY GROVE RD STE 300, ROCKVILLE, MD 20850(301) 340-3252(301) 340-1423 Get Directions Write a Review

NPPES record last updated: August 22, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jacky Kim Chun Pa-c NPPES

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

JACKY KIM CHUN PA-C (NPI 1164140109) is an individual medical provider in Rockville, Maryland, licensed in Maryland (C0008525) and active in the NPI registry since August 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1164140109
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameJACKY KIM CHUNCredential: PA-C
Location Address15001 SHADY GROVE RD STE 300Rockville, MD 20850-6353
Mailing Address15001 Shady Grove Rd Ste 300Rockville, MD 20850-6353 · (301) 340-3252 · Fax (301) 340-1423
Phone(301) 340-3252
Fax(301) 340-1423
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateAugust 16, 2022
Last NPPES UpdateAugust 22, 2025
NPPES CertifiedAugust 22, 2025
✔ NPI 1164140109 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in MD · C0008525
15001 SHADY GROVE RD STE 300, Rockville, MD 20850
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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 and accepts Medicare assignment

Jacky Kim Chun Pa-c 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 ID4789053778
PECOS Enrollment IDI20221216000759
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.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
102 services102 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
43 services41 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
27 services27 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
22 services22 patients
New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202
This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.
12 services12 patients

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

86.79/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality86.46
Promoting Interoperability97
Improvement Activities40
Cost72

Other Providers at the Same Location NPPES 15

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

CAPITAL DIGESTIVE CARE, LLC
Internal Medicine (Gastroenterology)
15001 SHADY GROVE RD STE 300
ROCKVILLE, MD 20850
Montgomery County (301) 340-3252
SARIT TOLTZIS KIPNIS
Internal Medicine (Gastroenterology)
15001 SHADY GROVE RD STE 300
ROCKVILLE, MD 20850
Montgomery County (301) 340-3252
SCOTT RICHARD FRIEDBERG MD
Internal Medicine (Gastroenterology)
15001 SHADY GROVE RD STE 300
ROCKVILLE, MD 20850
Montgomery County (301) 340-3252
KELLY GRAY NELSON
Nurse Practitioner (Gerontology)
15001 SHADY GROVE RD STE 300
ROCKVILLE, MD 20850
Montgomery County (301) 340-3252
MR. WILLIAM R. STERN M.D.
Internal Medicine (Gastroenterology)
15001 SHADY GROVE RD STE 300
ROCKVILLE, MD 20850
Montgomery County (301) 340-3252
DR. JEFFREY YOUNG KIM M.D.
Internal Medicine (Gastroenterology)
15001 SHADY GROVE RD STE 300
ROCKVILLE, MD 20850
Montgomery County (301) 340-3252
GLORIA E VASQUEZ ZELAYA DNP
Nurse Practitioner (Adult Health)
15001 SHADY GROVE RD STE 300
ROCKVILLE, MD 20850
Montgomery County (301) 340-3252
LEIGH BORNSTEIN LURIE MD
Internal Medicine (Gastroenterology)
15001 SHADY GROVE RD STE 300
ROCKVILLE, MD 20850
Montgomery County (301) 340-3252

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 Jacky Chun's NPI number?

The NPI number for Jacky Chun is 1164140109. It was assigned to this individual provider in the NPPES registry on August 16, 2022.

Where is Jacky Chun located?

Jacky Chun practices at 15001 Shady Grove Rd Ste 300, Rockville, MD 20850. The listed phone number is (301) 340-3252.

What is Jacky Chun's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Jacky Chun enrolled in Medicare?

Yes. Jacky Chun is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jacky Chun was last updated on August 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.