Individual provider Active NPI

Anna Chung, PA-C

  • Physician Assistant
  • Montville, NJ
National Provider Identifier
1053535880
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00094300 Issued in NJ
Practice address
170 Changebridge Rd BLDG C3
Montville, NJ 07045-9112
Phone
(973) 575-5540
Fax
(973) 575-4885
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00094300 NJ Primary

Addresses

Primary practice location

170 Changebridge Rd BLDG C3
Montville, NJ 07045-9112

Mailing address

402 Lippincott Dr
Marlton, NJ 08053-4112
Phone (856) 782-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20091203000051 NJ Practitioner - Physician Assistant 8123115581 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Consensus Medical Group LLCGroup PAC ID 2961748181, 138 clinicians

Practice addresses (Care Compare)

150 Fairfield Rd
Fairfield, NJ 07004-2407
Phone (973) 227-0020

3799 US Hwy 46
Suite 209
Parsippany, NJ 07054-1060
Phone (973) 334-8010

63 Beaverbrook Rd
Suite 101
Lincoln Park, NJ 07035-1440
Phone (973) 696-1087

706 Bergen Ave
Suite 2
Jersey City, NJ 07306-4802
Phone (201) 464-8888

781 State Route 15 S
Suite B
Lake Hopatcong, NJ 07849-2339
Phone (862) 299-3100

Hospital & facility affiliations

  • Patient Care Home health agency, West Orange, NJ, CCN 317060
  • Morristown Medical Center Hospital, Morristown, NJ, CCN 310015
  • Saint Clare'S Hospital/ Denville Campus Hospital, Denville, NJ, CCN 310050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Marc Feingold MD LLC Current Accepting new patients
Practice Associates Medical Group PastSince Sep 2, 2014 Accepting new patients
CMG Medical Group I LLC Past Accepting new patients

Locations

420 Bridge Plaza Dr
Manalapan, NJ 07726
Phone (732) 536-8008

Interoperability endpoints

  • Direct secure messaging: anna.chung.1@18614.direct.athenahealth.com

Organizations & group practices 5

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 3

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1053535880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 LIPPINCOTT DR",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534112",
            "telephone_number": "856-782-3300",
            "fax_number": "856-504-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 CHANGEBRIDGE RD BLDG C3",
            "city": "MONTVILLE",
            "state": "NJ",
            "postal_code": "070459112",
            "telephone_number": "973-575-5540",
            "fax_number": "973-575-4885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "ANNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00094300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montville, NJ

Sources for this page

Verify at the official NPI Registry.