Individual provider Active NPI

Yu-Ting Julie Chung, O.D.

  • Optometrist
  • Leesburg, VA
National Provider Identifier
1053623306
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618001955 Issued in VA
Practice address
19360 Compass Creek Pkwy
Leesburg, VA 20175-5445
Phone
(571) 258-4644
Fax
(571) 248-4643
NPI assigned
Jul 1, 2010
Last updated
Jun 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001955 VA Primary

Addresses

Primary practice location

19360 Compass Creek Pkwy
Leesburg, VA 20175-5445

Mailing address

43091 Old Gallivan Ter
Ashburn, VA 20147-7437
Phone (571) 217-1376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110208000079 VA Practitioner - Optometry 6002095866 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Eye Center, PC CurrentSince Oct 1, 2021 Accepting new patients
Virginia Eye Center P.C. CurrentSince Oct 1, 2021 Accepting new patients

Locations

19441 Golf Vista Plz
Ste 320
Leesburg, VA 20176
Phone (703) 858-9800

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1053623306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43091 OLD GALLIVAN TER",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201477437",
            "telephone_number": "571-217-1376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19360 COMPASS CREEK PKWY",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201755445",
            "telephone_number": "571-258-4644",
            "fax_number": "571-248-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "YU-TING",
        "middle_name": "JULIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-01",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.