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JEONGMI MOON
NPI 1336566785
Psychologist - Clinical in San Diego, CA

Active since March 24, 2014PECOS EnrolledAccepts Medicare Assignment
5050 LOTUS ST APT 28, SAN DIEGO, CA 92107(619) 736-0333 Get Directions Write a Review

NPPES record last updated: November 30, 2022. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Nov 30, 2022, Nov 21, 2022 (2 updates tracked since 2022).

About Jeongmi Moon NPPES

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

JEONGMI MOON (NPI 1336566785) is an individual clinical provider in San Diego, California, licensed in California (PSY33750) and active in the NPI registry since March 2014. She is enrolled in Medicare PECOS, maintains a secondary practice location in San Diego, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1336566785
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameJEONGMI MOON
Location Address5050 LOTUS ST APT 28San Diego, CA 92107-1373
Mailing Address5050 Lotus St Apt 28San Diego, CA 92107-1373 · (619) 736-0333
Phone(619) 736-0333
Sole ProprietorYes
Medical School CMSOtherGraduated 2016
Enumeration DateMarch 24, 2014
Last NPPES UpdateNovember 30, 20222 updates tracked since enumeration
NPPES CertifiedNovember 30, 2022
✔ NPI 1336566785 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in CA · PSY33750
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
Also ListedPsychologistTaxonomy 103T00000X · License PSY33750 (CA)
5050 LOTUS ST APT 28, San Diego, CA 92107
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Secondary Practice Location 1

Location 15348 University Ave, Suite 101San Diego, CA 92105-8025 · Phone (619) 229-2999

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

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

Jeongmi Moon 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 ID4981074572
PECOS Enrollment IDI20221222001186
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92107 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
$184.71 typical visit price
range $62.10 – $184.71
Typical copayment $46.17 (range $15.52 – $46.17)
Most-billed visit code 99205
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
Most-billed visit code 99214
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

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

DR.MOON PSYCHOLOGY CENTER
Community/Behavioral Health
5050 LOTUS ST APT 28
SAN DIEGO, CA 92107
San Diego County (619) 674-9764

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 Jeongmi Moon's NPI number?

The NPI number for Jeongmi Moon is 1336566785. It was assigned to this individual provider in the NPPES registry on March 24, 2014.

Where is Jeongmi Moon located?

Jeongmi Moon practices at 5050 Lotus St Apt 28, San Diego, CA 92107. The listed phone number is (619) 736-0333.

What is Jeongmi Moon's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Jeongmi Moon enrolled in Medicare?

Yes. Jeongmi Moon 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.

What insurance does Jeongmi Moon accept?

Health plans from Providence Health Plan list Jeongmi Moon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jeongmi Moon was last updated on November 30, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.