Taylor Keiichi Chong, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA61407244 Issued in WA

Practice address

5350 Tallman Ave NW Ste 500
Seattle, WA 98107-5902

Phone

(206) 784-8833

Fax

(206) 784-0676

NPI assigned

Aug 31, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Polyclinic PLLCGroup PAC ID 2163328196, 364 clinicians

Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3889/brand/1/csg/1/fhir/r4
• Direct secure messaging: taylor.chong.p2@direct.proliance.nextgenshare.com
• Direct secure messaging: tchong90587@direct.tecmc.com

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.

• Optum Care Washington PLLC

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1831186766
  Medicare reassignment Care Compare group
• The Polyclinic PLLC

  • Audiologist
  • Seattle, WA
  • NPI 1174594634
  Medicare reassignment Care Compare group
• Proliance Surgeons Inc P S

  • Orthopaedic Surgery Physician
  • Seattle, WA
  • NPI 1023170313
  Medicare reassignment
• Optum Care Washington PLLC

  • Durable Medical Equipment & Medical Supplies
  • Marysville, WA
  • NPI 1194428425
  NPD
• Optum Care Washington PLLC

  • Ambulatory Surgical Clinic/Center
  • Arlington, WA
  • NPI 1366154304
  NPD
• Proliance Surgeons Inc P S

  • Orthopaedic Surgery Physician
  • Renton, WA
  • NPI 1235091463

  Surgical

  NPD
• Proliance Surgeons Inc., P.S.

  • Multi-Specialty Clinic/Center
  • Edmonds, WA
  • NPI 1386687747

  Surgical

  NPD
• The Polyclinic

  • Ambulatory Surgical Clinic/Center
  • Seattle, WA
  • NPI 1073944039
  NPD
• The Polyclinic PLLC

  • Durable Medical Equipment & Medical Supplies
  • Tacoma, WA
  • NPI 1831411487
  NPD
• The Polyclinic PLLC

  • Durable Medical Equipment & Medical Supplies
  • Seattle, WA
  • NPI 1346620200
  NPD (past)

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1033887443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 N 45TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981036907",
            "telephone_number": "206-633-8100",
            "fax_number": "206-633-6107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 TALLMAN AVE NW STE 500",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981075902",
            "telephone_number": "206-784-8833",
            "fax_number": "206-784-0676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2409 N 45th St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981036907",
            "country_code": "US",
            "telephone_number": "206-633-8100",
            "fax_number": "206-633-6107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHONG",
        "first_name": "TAYLOR",
        "middle_name": "KEIICHI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-31",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA61407244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2257812",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dennis Chong, M.D.
• Elisa Chong, M.D.
• Jessica Chong
• Sheri Sene Yene Chong, PHARMD
• Sherri Lyn Wai Jun Chong, DMD, MS
• Tracie Ann Chong, MD
• Wei Yee Chong, MS, NCC
• Yoo Jung Chong, MA ED, LMHCA
• Jia Wen Choo, PT
• Rona Choo

• Surgical Physician Assistant in Seattle, WA
• Providers in Seattle, WA by specialty
• Surgical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.