Nicole Marie Chong, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9101662 Issued in FL

Practice address

1613 NW 136TH Ave
Suite 200
Sunrise, FL 33323-2853

Phone

(800) 437-2672

Fax

(281) 851-1416

NPI assigned

Aug 3, 2005

Last updated

Sep 6, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Neurosurgical Consultants of South Florida LLCGroup PAC ID 9931091204, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Boca Raton Regional Hospital Hospital, Boca Raton, FL, CCN 100168
• Delray Medical Center Hospital, Delray Beach, FL, CCN 100258

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Neurosurgical Consultants of South Florida, LLC

  • Neurological Surgery Physician
  • Delray Beach, FL
  • NPI 1013975291
  Medicare reassignment Care Compare group
• Phoenix Emergency Medicine of Broward LLC

  • Emergency Medicine Physician
  • Coral Springs, FL
  • NPI 1871542969
  Medicare reassignment NPD
• Sterling Emergency Services of Florida PA

  • Emergency Medicine Physician
  • West Palm Beach, FL
  • NPI 1295720241
  Medicare reassignment
• Neurosurgical Consultants of South Florida LLC

  • Neurological Surgery Physician
  • Palm Beach Gardens, FL
  • NPI 1659027878
  NPD
• Phoenix Emergency Medicine of Broward LLC

  • Emergency Medicine Physician
  • Deerfield Beach, FL
  • NPI 1407805591
  NPD
• Sterling Emergency Services of Florida PA

  • Emergency Medicine Physician
  • Boynton Beach, FL
  • NPI 1578814570

  Physician Assistant

  NPD
• Greater Texas Emergency Consultants, P.a.

  • Emergency Medicine Physician
  • Houston, TX
  • NPI 1043296932
  NPD (past)
• ZSH Healthcare Associates, PLLC

  dba Sugar Land Urgent Care Center

  • Urgent Care Clinic/Center
  • Sugar Land, TX
  • NPI 1255317137
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Boca Raton Regional Hospital, Inc.

  • General Acute Care Hospital
  • Boca Raton, FL
  • NPI 1902826779
  Care Compare affiliation
• Delray Medical Center, Inc.

  dba Delray Medical Center

  • General Acute Care Hospital
  • Delray Beach, FL
  • NPI 1326078288
  Care Compare affiliation

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567728000000",
    "number": "1063413748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11249 BRANDYWINE LAKE WAY",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334734891",
            "telephone_number": "561-926-3328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 NW 136TH AVE",
            "address_2": "SUITE 200",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232853",
            "telephone_number": "800-437-2672",
            "fax_number": "281-851-1416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHONG",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-03",
        "last_updated": "2019-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03403",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9101662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P00458829",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291078100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Children's Center for Development and Behavior
• Carolyn M Chilvers, CRNA
• Martha R Chipi, M.D.
• Yicenia Chirino Portal Sr.
• Simon Choi, PHARMD
• Jon-Bruce Chopyk, MD
• Sudhir K. Choudhary, MD
• Neil Leonard Christen, M.D.
• Connie Christine Christensen, CRNA ARNP
• Justin Eric Dychingco Chua

• Medical Physician Assistant in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2019; 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.