Mary Ann M. Chung, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95019761 Issued in CA

Practice address

801 S Chevy Chase Dr Ste 250
Glendale, CA 91205-4433

Phone

(818) 265-2264

NPI assigned

Feb 22, 2022

Sex

Female

Sole proprietor

No

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 CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Comprehensive Community Health Centers IncGroup PAC ID 9638082456, 47 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles (2 of 3)

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Comprehensive Community Health Centers Inc

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1356362743
  Medicare reassignment Care Compare group NPD
• Comprehensive Community Health Centers, Inc

  • Family Medicine Physician
  • Arleta, CA
  • NPI 1346951654
  NPD

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

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645920000000",
    "number": "1033865704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S CHEVY CHASE DR STE 250",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912054433",
            "telephone_number": "818-265-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S CHEVY CHASE DR STE 250",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912054433",
            "telephone_number": "818-265-2264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "MARY ANN",
        "middle_name": "M.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-22",
        "last_updated": "2022-02-27",
        "certification_date": "2022-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95019761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elianne Chung, SLP
• Esther Chung, O.D.
• Hyun Soo Chung, L.AC.
• Jenny Chung
• Justin Han Chung, DPT
• Melissa Mhin Kyung Chung, FNP
• Mona Lai King Chung, MD
• Steven Chuong
• Christopher Jules Ciamaichelo, CRNA
• Ciambotti-Titizian Chiropractic, Inc

• Family Nurse Practitioner in Glendale, CA
• Providers in Glendale, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2022; 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.