TAE YOON WON NURSE PRACTITIONER
NPI 1356035653
Nurse Practitioner in Stanton, CA

Q: What is Tae Won's NPI number?

The NPI number for Tae Won is 1356035653. It was assigned to this individual provider in the NPPES registry on June 8, 2023.

Q: What is Tae Won's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Tae Won was last updated on October 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since June 08, 2023PECOS Enrolled

12362 BEACH BLVD STE 10, STANTON, CA 90680(714) 248-9500 Get Directions Write a Review

NPPES record last updated: October 18, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 18, 2023, Jun 8, 2023 (2 updates tracked since 2023).

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About Tae Yoon Won Nurse Practitioner NPPES

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

TAE YOON WON NURSE PRACTITIONER (NPI 1356035653) is an individual nurse practitioner in Stanton, California, licensed in California (95022157) and active in the NPI registry since June 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1356035653

Entity TypeIndividualMale

Primary Taxonomy363L00000X

Provider Legal NameTAE YOON WONCredential: NURSE PRACTITIONER

Location Address12362 BEACH BLVD STE 10Stanton, CA 90680-3944

Mailing Address12362 Beach Blvd Ste 10Stanton, CA 90680-3944 · (714) 248-9500

Phone(714) 248-9500

Sole ProprietorNo

Enumeration DateJune 8, 2023

Last NPPES UpdateOctober 18, 20232 updates tracked since enumeration

NPPES CertifiedOctober 18, 2023

✔ NPI 1356035653 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in CA · 95022157

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

12362 BEACH BLVD STE 10, Stanton, CA 90680

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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)

Tae Yoon Won Nurse Practitioner 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90680 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

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

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 12

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

DR. JUSTIN TONY CHUNG D.D.S.

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