Individual provider Active NPI

Antony Fu-Chin Chu, MD

  • Clinical Cardiac Electrophysiology Physician
  • Bemidji, MN
National Provider Identifier
1063573764
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
MD13862 Issued in RI
Practice address
1300 Anne St NW
Bemidji, MN 56601-5103
Phone
(218) 333-5000
NPI assigned
Dec 13, 2006
Last updated
Jun 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD425544 PA
Cardiovascular Disease Physician 207RC0000X 25MA08201400 NJ
Cardiovascular Disease Physician 207RC0000X MT179943 PA
Cardiovascular Disease Physician 207RC0000X MD425544 PA
Clinical Cardiac Electrophysiology Physician 207RC0001X 72112-20 WI
Clinical Cardiac Electrophysiology Physician 207RC0001X MD425544 PA
Clinical Cardiac Electrophysiology Physician 207RC0001X MD13862 RI Primary

Addresses

Primary practice location

1300 Anne St NW
Bemidji, MN 56601-5103

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

593 Eddy St
APC Building 743
Providence, RI 02903-4923
Phone (401) 444-8689

Other practice location 2

2315 Myrtle St Ste 190
Erie, PA 16502-4604
Phone (814) 453-7767

Other practice location 3

2500 NE Neff Rd
Bend, OR 97701-6015
Phone (541) 388-4333

Other practice location 4

700 S Park St Ste A
Madison, WI 53715-1830
Phone (608) 260-2900

Other identifiers 1

IdentifierTypeStateIssuer
1063573764MedicaidWI

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address achu286281@direct.ahn.org
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address achu420646@direct-ehr-ssmhc.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, RI, ND, OR, MN5 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20080715000239 PA Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4880792530 Reassigns benefits to 1 organization
I20120924000626 RI Practitioner - Cardiac Electrophysiology 4880792530 Reassigns benefits to 2 organizations
I20200707002908 ND Practitioner - Cardiovascular Disease (Cardiology) 4880792530 Reassigns benefits to 1 organization
I20210427002849 OR Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 4880792530 Reassigns benefits to 1 organization
I20230302002390 MN Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 4880792530 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Yale University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians
Bay Area Hospital DistrictGroup PAC ID 2163331000, 117 clinicians

Practice addresses (Care Compare)

1300 Anne St NW
Bemidji, MN 56601-5103
Phone (218) 333-5000

1611 Anne St NW
Bemidji, MN 56601-5114
Phone (218) 333-5000

164 Summit Ave
Providence, RI 02906-2853

1775 Thompson Rd
Coos Bay, OR 97420-2125
Phone (541) 269-8280

185 A High Service Ave
North Providence, RI 02904-5114
Phone (401) 354-6050

185 High Service Ave
North Providence, RI 02904-5114
Phone (401) 354-6050

2650 N 17TH St
Coos Bay, OR 97420-2134
Phone (541) 269-8282

407 E Ave
Suite 120
Pawtucket, RI 02860-5290
Phone (401) 475-2505

593 Eddy St
Providence, RI 02903-4923

593 Eddy St Apc
Suite 6
Providence, RI 02903-4923
Phone (401) 793-9172

593 Eddy St George BLDG 1St Floor
Providence, RI 02903-4923
Phone (401) 793-9166

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA08201400NJMDCardiovascular Disease Physician
MT179943PAMDCardiovascular Disease Physician
MD425544PAMDClinical Cardiac Electrophysiology Physician
MD13862RIMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Alexius Medical Center CurrentSince Mar 1, 2020 Accepting new patients
Wellspan Medical Group CurrentSince Oct 2, 2020 Accepting new patients
St. Alexius Medical Center Specialist CurrentSince Mar 1, 2020 Accepting new patients
Bay Area Hospital District CurrentSince Jan 16, 2021 Accepting new patients
Bay Area Hospital District CurrentSince Jan 16, 2021 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Sep 1, 2012 Accepting new patients
Sanford Health of Northern Minnesota CurrentSince Feb 6, 2023 Accepting new patients
Wellspan Medical Group CurrentSince Oct 2, 2020 Accepting new patients
The Miriam Hospital CurrentSince Jul 1, 2012 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Sep 1, 2012 Accepting new patients
Wellspan Medical Group Current Accepting new patients
The Miriam Hospital Current Accepting new patients
Sanford Health of Northern Minnesota Current Accepting new patients
Sanford Health of Northern Minnesota CurrentSince Feb 6, 2023 Accepting new patients
Lifespan Corporation Current Accepting new patients
The Miriam Hospital Current Accepting new patients
The Miriam Hospital Cardiovascular Disease CurrentSince Jul 1, 2012 Accepting new patients
Cardiovascular Associates of the Delaware Valley,P a Cardiovascular Disease PastSince Sep 1, 2023 Accepting new patients
Pennsylvania Heart and Vascular Group, P.C. Cardiovascular Disease Past Accepting new patients

Locations

Dept LA 25339
Pasadena, CA 91185

1300 Anne St NW
Bemidji, MN 56601
Phone (218) 333-5794

1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020

1400 Highway 71
Intl Falls, MN 56649
Phone (218) 283-4481

900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300

1775 Thompson Rd
Coos Bay, OR 97420
Phone (541) 269-8090

2650 N 17th St
Coos Bay, OR 97420
Phone (541) 267-5411

450 S Washington St
Ste A
Gettysburg, PA 17325
Phone (717) 339-3105

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

208 Collyer St
Ste 100
Providence, RI 02904
Phone (401) 793-7191

593 Eddy St
Providence, RI 02903

593 Eddy St
Bldg 743
Providence, RI 02903
Phone (401) 444-8689

Interoperability endpoints

  • Direct secure messaging: achu128924@secure.stcharleshealthcare.org
  • Direct secure messaging: achu286281@direct.ahn.org
  • Direct secure messaging: achu420646@direct-ehr-ssmhc.com
  • Direct secure messaging: achu7323@brownhealth.medalliesdirect.net

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 8

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1063573764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 ANNE ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015103",
            "telephone_number": "218-333-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 Eddy St",
            "address_2": "APC Building 743",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-8689",
            "fax_number": "401-444-4652",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2315 Myrtle St Ste 190",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165024604",
            "country_code": "US",
            "telephone_number": "814-453-7767",
            "fax_number": "814-454-6667",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 NE Neff Rd",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977016015",
            "country_code": "US",
            "telephone_number": "541-388-4333",
            "fax_number": "541-388-3446",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 S Park St Ste A",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537151830",
            "country_code": "US",
            "telephone_number": "608-260-2900",
            "fax_number": "608-260-2956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHU",
        "first_name": "ANTONY",
        "middle_name": "FU-CHIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD425544",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA08201400",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MT179943",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD425544",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "WI",
            "license": "72112-20",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "PA",
            "license": "MD425544",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "RI",
            "license": "MD13862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063573764",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "achu286281@direct.ahn.org",
            "affiliation": "N",
            "address_1": "2315 Myrtle St Ste 190",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "165024604",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "700 S Park St Ste A",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "achu420646@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "achu420646@direct-ehr-ssmhc.com",
            "address_1": "700 S Park St Ste A",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bemidji, MN

Sources for this page

Verify at the official NPI Registry.