NPIMap

Individual provider Active NPI

Jacquelin Ratunil Chua, MD

  • Rheumatology Physician
  • Montgomery, AL
National Provider Identifier
1033467196
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
036138068 Issued in IL
Practice address
1722 Pine St
Montgomery, AL 36106
Phone
(334) 293-8000
NPI assigned
Aug 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 036138068 IL Primary

Addresses

Primary practice location

1722 Pine St
Montgomery, AL 36106

Mailing address

1611 W Harrison St
Suite 510
Chicago, IL 60612-4861
Phone (312) 563-2800

Other practice location 1

1611 W Harrison St
Suite 510
Chicago, IL 60612-4861
Phone (312) 563-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20180920002923 AL Practitioner - Rheumatology 9133419674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Hospital and Clinic, Inc 119 clinicians

Practice addresses (Care Compare)

1722 Pine St
Suite 405
Montgomery, AL 36106-1159
Phone (334) 293-6904

Hospital & facility affiliations

  • Jackson Hospital & Clinic Inc Hospital, Montgomery, AL, CCN 010024
  • Prattville Baptist Hospital Hospital, Prattville, AL, CCN 010108
  • Elmore Community Hospital Hospital, Wetumpka, AL, CCN 010097
  • Community Hospital Inc Hospital, Tallassee, AL, CCN 010034
  • Baptist Medical Center East Hospital, Montgomery, AL, CCN 010149

Merit-based Incentive Payment System (MIPS)

Final score
85.48 of 100Reported as individual
Quality
66.06
Promoting interoperability
100
Improvement activities
40
Cost
85.54

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Hospital & Clinic, Inc. CurrentSince Aug 1, 2018 Accepting new patients
Jackson Hospital and Clinic, Inc. Current Accepting new patients
Jackson Hospital and Clinic, Inc. Rheumatology CurrentSince Aug 1, 2018 Accepting new patients
Jackson Hospital & Clinic, Inc. Past Accepting new patients

Locations

1900 5th Ave N
Birmingham, AL 35203

1725 Pine St
Montgomery, AL 36106
Phone (334) 293-8000

1722 Pine St
Ste 503
Montgomery, AL 36106
Phone (334) 240-2337

1722 Pine St
Ste 405
Montgomery, AL 36106
Phone (334) 293-6904

Interoperability endpoints

  • Direct secure messaging: jacquelin.chua.1@9186.direct.athenahealth.com

Organizations & group practices 7

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.

Hospital & facility affiliations 5

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": "1345507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1033467196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST",
            "address_2": "SUITE 510",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "312-563-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 PINE ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "36106",
            "telephone_number": "334-293-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 W Harrison St",
            "address_2": "Suite 510",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606124861",
            "country_code": "US",
            "telephone_number": "312-563-2800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUA",
        "first_name": "JACQUELIN",
        "middle_name": "RATUNIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-21",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "IL",
            "license": "036138068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.