Chung Ho Shum, M.D., PH.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

017501 Issued in ME

Practice address

417 State St
Webber West 541
Bangor, ME 04401-6641

Phone

(207) 941-8200

NPI assigned

Jan 24, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pathology

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dahl Chase Pathology Associates PAGroup PAC ID 8820995947, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033
• St Joseph Hospital Hospital, Bangor, ME, CCN 200001
• Northern Light Mercy Hospital Hospital, Portland, ME, CCN 200008
• Northern Light Maine Coast Hospital Hospital, Ellsworth, ME, CCN 200050
• Cary Medical Center Hospital, Caribou, ME, CCN 200031

Merit-based Incentive Payment System (MIPS)

Final score

94.83 of 100Reported as group

Quality

82.8

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Dahl Chase Pathology Associates, PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Bangor, ME
  • NPI 1992726913
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• City of Caribou

  • General Acute Care Hospital
  • Caribou, ME
  • NPI 1780615492
  Care Compare affiliation
• Eastern Maine Medical Center

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1790789147
  Care Compare affiliation
• Maine Coast Regional Health Facilities

  • General Acute Care Hospital
  • Ellsworth, ME
  • NPI 1740249739
  Care Compare affiliation
• Mercy Hospital

  • General Acute Care Hospital
  • Portland, ME
  • NPI 1427313048
  Care Compare affiliation
• Mercy Hospital

  • General Acute Care Hospital
  • Portland, ME
  • NPI 1629078712
  Care Compare affiliation
• St. Joseph Hospital

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1154321545
  Care Compare affiliation

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185148800000",
    "number": "1013062850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 SARATOGA AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014218",
            "telephone_number": "207-945-5795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 STATE ST",
            "address_2": "WEBBER WEST 541",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016641",
            "telephone_number": "207-941-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUM",
        "first_name": "CHUNG",
        "middle_name": "HO",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "PA",
            "license": "MD428108",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A98612",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "ME",
            "license": "017501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hatem T Shoukeir, M.D.
• Dennis Lee Shubert, M.D.
• Prem Shanker Shukla, MD
• Ilsa Annetta Shulman, MD
• Scott D Shulman, MD
• Kaylee Shute Knowles, AUD
• Xafsa Shute
• Amy Sibley, LMSW-CC
• Woyessa Duressa Sida
• Amanda L. Sidell, LCSW

• Anatomic Pathology & Clinical Pathology Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Anatomic Pathology & Clinical Pathology Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; 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.