Kenneth Chung, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2907 Issued in CO

Practice address

14451 Orchard Pkwy
Westminster, CO 80023-9174

Phone

(303) 451-0598

Fax

(303) 451-0626

NPI assigned

Aug 1, 2011

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

New England College of Optometry, 2011

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Blue Wave Eye Doctors Professional Limited Liability Company

  • Optometrist
  • Everett, WA
  • NPI 1053060475
  Medicare reassignment
• The Eye Q Connection, PLLC

  • Corneal and Contact Management Optometrist
  • Westminster, CO
  • NPI 1518416825
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479600000000",
    "number": "1003194507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14770 ORCHARD PKWY",
            "address_2": "UNIT 108",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800239127",
            "telephone_number": "626-607-7500",
            "fax_number": "303-451-0626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14451 ORCHARD PKWY",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800239174",
            "telephone_number": "303-451-0598",
            "fax_number": "303-451-0626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-01",
        "last_updated": "2016-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2907",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14542TLG",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1976",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042856",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heidi Christophersen, RN
• Kurt Chronister
• Julie Chrzanowski, M.A.
• Stephanie M Chu, DO
• Thomas Kent Chubb, D.D.S.
• Sue Jean Chung, O.T.R.
• Jean M Church, LPCC
• Isabel Ciaptacz, RN
• William John Ciccone II, M.D.
• Linda Ann Ciganovic, DPT DOCTOR OF PHYSIC

• Optometrist in Westminster, CO
• Providers in Westminster, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.