Nicola Marie Chung, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY 7307 Issued in FL

Practice address

1021 Ives Dairy Rd
Suite 119
North Miami Beach, FL 33179-2537

Phone

(305) 490-8590

NPI assigned

Jun 7, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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

• Nicola Chung, PH.D., LLC

  • Clinical Psychologist
  • North Miami Beach, FL
  • NPI 1346312923
  Medicare reassignment Authorized official
• Jack R Weitz PHD PA

  • Psychologist
  • N Miami Beach, FL
  • NPI 1063579662
  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379116800000",
    "number": "1003856121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 IVES DAIRY RD",
            "address_2": "SUITE 119",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331792537",
            "telephone_number": "305-490-8590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 IVES DAIRY RD",
            "address_2": "SUITE 119",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331792537",
            "telephone_number": "305-490-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "NICOLA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2013-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 7307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in North Miami Beach, FL
• Providers in North Miami Beach, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2013; 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.