DR. ILSUP YOON – Diagnostic Radiology Physician, NPI 1215476155

DR. ILSUP YOON is a healthcare provider. based in Fort riley, Kansas. specializing in DIAGNOSTIC RADIOLOGY. They hold a License No. 31198 (NE). The NPI Number for DR. ILSUP YOON is 1215476155

Main info

Male
9 Years Of Experience
Name
DR. ILSUP YOON
NPI
1215476155
Phone
(785) 239-7296
Address
650 HUEBNER RD
Enumeration Date
13 February 2017
Last Update Date
16 March 2023

Doctor Profile

Medical School Name
R FRANKLIN UNIVERSITY OF MED & SCI/CHICAGO MEDICAL SCHOOL
Secondary Phone
2172246423
Graduation Year
2017 (9 years ago)
PAC ID
2769854009
Group Practice PAC ID
3072422534
Professional Enrollment ID
I20240304001305
Address ID
IL623055875QU4800XSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness75
Years active:9State licenses:2Digital endpointsOther names

298 DIAGNOSTIC RADIOLOGY in KS

Provider Addresses for DR. ILSUP YOON

  • 650 HUEBNER RD

    FORT RILEY, KS 664424030

    Phone: (785) 239-7296

    Type: Location

  • Center for the Intrepid, 3551, Roger Brooke Drive, San Antonio, Bexar County, Texas, 78234, United States

    JBSA FORT SAM HOUSTON

    SAN ANTONIO, TX 782344504

    Phone: (210) 228-6419

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-05-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 6 Medicare enrollment records; no due dates published yet.

Enrollment records

6

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230214001571IDiagnostic RadiologyMITBD
I20230611000093IDiagnostic RadiologyKSTBD
I20240223000616IDiagnostic RadiologyMOTBD
I20240304001305IDiagnostic RadiologyILTBD
I20240401000214IDiagnostic RadiologyKYTBD
I20240521003604IDiagnostic RadiologyNYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
71045X-ray of chest, 1 view7675$0
70450Ct scan head or brain without contrast2120$0
View full utilization report →

Insurance plans in this area (ZIP 66442)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3072422534View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YIL
Nurse PractitionerIL
N E U R O L O G YMI
Radiation OncologyIL
Nurse PractitionerIL
Nurse PractitionerIL
Pain Management, AnesthesiologyIL
Family Practice, Emergency MedicineIL
Nurse PractitionerIL
Family PracticeIL

Reviews

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Frequently asked questions

How is DR. ILSUP YOON identified in CMS data?
CMS-hosted NPPES data lists DR. ILSUP YOON with NPI 1215476155.
Is DR. ILSUP YOON listed as active for patients and plans?
The listing shows DR. ILSUP YOON as active in the NPI system.
What is DR. ILSUP YOON's specialty?
The listing groups DR. ILSUP YOON with Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.
Where is DR. ILSUP YOON based?
DR. ILSUP YOON is tied to Fort Riley, Kansas in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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