1. Home
  2. Directory
  3. California
  4. Los Angeles
  5. Nurse Practitioner
  6. NPI Profile

MOONSUN JEONG NURSE PRACTITIONER
NPI 1740863828
Nurse Practitioner - Family in Los Angeles, CA

Active since May 05, 2021PECOS Enrolled
3255 WILSHIRE BLVD STE 120, LOS ANGELES, CA 90010(213) 235-2500(213) 355-8714 Get Directions Write a Review

NPPES record last updated: September 16, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 16, 2021, May 5, 2021 (2 updates tracked since 2021).

About Moonsun Jeong Nurse Practitioner NPPES

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

MOONSUN JEONG NURSE PRACTITIONER (NPI 1740863828) is an individual family provider in Los Angeles, California, licensed in California (NP95017339) and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1740863828
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameMOONSUN JEONGCredential: NURSE PRACTITIONER
Location Address3255 WILSHIRE BLVD STE 120Los Angeles, CA 90010-1405
Mailing Address3727 W 6th St Ste 210Los Angeles, CA 90020-5108
Phone(213) 235-2500
Fax(213) 355-8714
Sole ProprietorNo
Enumeration DateMay 5, 2021
Last NPPES UpdateSeptember 16, 20212 updates tracked since enumeration
NPPES CertifiedSeptember 16, 2021
✔ NPI 1740863828 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · NP95017339
3255 WILSHIRE BLVD STE 120, Los Angeles, CA 90010
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Moonsun Jeong 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Moonsun Jeong reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Korean Health Education Information And Research Center
0.6 mi
Primary Care
3727 W 6TH ST STE 200
Los Angeles, CA 90020
  • Reassigned Medicare billing, California enrollment
  • 24 clinicians in this Medicare group
NPI 1437377454 (213) 235-2500
St. Johns Community Health
1.6 mi
Federally Qualified Health Center (FQHC)
1910 MAGNOLIA AVE
Los Angeles, CA 90007
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: St. John's Community Health
  • 404 clinicians in this Medicare group
NPI 1073653630 (213) 749-0947

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90010 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 9

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

KOREAN HEALTH, EDUCATION, INFORMATION AND RESEARCH CENTER
Clinic/Center (Primary Care)
3255 WILSHIRE BLVD STE 120
LOS ANGELES, CA 90010
Los Angeles County (213) 235-2500
MISS JENNY LOPEZ LCSW
Social Worker (Clinical)
3255 WILSHIRE BLVD STE 120
LOS ANGELES, CA 90010
Los Angeles County (213) 235-2500
LIZBETH ACOSTA PA-C, ATC
Physician Assistant
3255 WILSHIRE BLVD STE 120
LOS ANGELES, CA 90010
Los Angeles County (213) 235-2500
KYUNG JOON SUH
Social Worker (Clinical)
3255 WILSHIRE BLVD STE 120
LOS ANGELES, CA 90010
Los Angeles County (213) 235-1219
DR. LALEH MOKHBERI
Dentist
3255 WILSHIRE BLVD STE 120
LOS ANGELES, CA 90010
Los Angeles County (213) 235-2500
YUAN LIU M.D.
Family Medicine
3255 WILSHIRE BLVD STE 120
LOS ANGELES, CA 90010
Los Angeles County (213) 235-2500
DR. SOYEON CHIN M.D.
General Practice
3255 WILSHIRE BLVD STE 120
LOS ANGELES, CA 90010
Los Angeles County (213) 235-2500
CHRIS H CHANG
Family Medicine
3255 WILSHIRE BLVD STE 120
LOS ANGELES, CA 90010
Los Angeles County (213) 235-2500

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 Moonsun Jeong's NPI number?

The NPI number for Moonsun Jeong is 1740863828. It was assigned to this individual provider in the NPPES registry on May 5, 2021.

Where is Moonsun Jeong located?

Moonsun Jeong practices at 3255 Wilshire Blvd Ste 120, Los Angeles, CA 90010. The listed phone number is (213) 235-2500.

What is Moonsun Jeong's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Moonsun Jeong enrolled in Medicare?

Yes. Moonsun Jeong is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Moonsun Jeong's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Moonsun Jeong reassigns Medicare benefits to 2 organizations: Korean Health Education Information And Research Center (Los Angeles, CA) and St. Johns Community Health (Los Angeles, CA). Each 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 Moonsun Jeong'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 Moonsun Jeong was last updated on September 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.