NPIMap

Individual provider Active NPI

Michael Sung Chung, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Fairfax, VA
National Provider Identifier
1013948462
Registry record updated Jul 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
0101055898 Issued in VA
Practice address
2826 Old Lee Hwy
Suite 200
Fairfax, VA 22031-4323
Phone
(703) 206-0026
Fax
(703) 206-0029
NPI assigned
Jul 5, 2006
Last updated
Jul 31, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 0101055898 VA Primary

Addresses

Primary practice location

2826 Old Lee Hwy
Suite 200
Fairfax, VA 22031-4323

Mailing address

2826 Old Lee Hwy
Suite 200
Fairfax, VA 22031-4323
Phone (703) 206-0026

Other identifiers 2

IdentifierTypeStateIssuer
6802117MedicaidVA
495211100MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050407001026 DC Practitioner - Physical Medicine and Rehabilitation 3476500711 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Vernon Rehabilitation Medicine AssociatesGroup PAC ID 7214828086, 10 clinicians

Practice addresses (Care Compare)

2501 Parkers LN
Alexandria, VA 22306-3209
Phone (703) 664-7189

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Vernon Rehabilitation Medicine Associates CurrentSince Jul 1, 2020 Accepting new patients
Medical Faculty Associates, Inc CurrentSince Oct 21, 2017 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

900 23rd St NW
Washington, DC 20037
Phone (202) 715-4750

2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000

2826 Old Lee Hwy
Fairfax, VA 22031
Phone (407) 306-8441

2826 Old Lee Hwy
Ste 200
Fairfax, VA 22031
Phone (703) 206-0026

19440 Golf Vista Plz
Ste 210
Leesburg, VA 20176
Phone (703) 729-0141

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1013948462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2826 OLD LEE HWY",
            "address_2": "SUITE 200",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314323",
            "telephone_number": "703-206-0026",
            "fax_number": "703-206-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2826 OLD LEE HWY",
            "address_2": "SUITE 200",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314323",
            "telephone_number": "703-206-0026",
            "fax_number": "703-206-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "MICHAEL",
        "middle_name": "SUNG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "VA",
            "license": "0101055898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6802117",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "495211100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.