Gary S Chubak, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

127280 Issued in NY

Practice address

21418 24TH Ave
Bayside, NY 11360-2219

Phone

(718) 428-6000

Fax

(718) 423-5102

NPI assigned

Nov 9, 2006

Last updated

Sep 14, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 NY

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

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  • NPI 1831438662
  NPD (past)

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252886400000",
    "number": "1114097896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21418 24TH AVE",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602219",
            "telephone_number": "718-428-6000",
            "fax_number": "718-423-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21418 24TH AVE",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602219",
            "telephone_number": "718-428-6000",
            "fax_number": "718-423-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUBAK",
        "first_name": "GARY",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2009-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "127280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00434331",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Choice Family Medicine
• Angela Un Chong, PA
• Miae Chong
• Rushina Christie, OTR/L
• Spyridon Christoforatos, DDS
• Hee Eun Chun
• Soo Ah Chun
• Justin Jongkyu Chung
• Sojin Chung, L.AC
• Timothy Chung

• Ophthalmology Physician in Bayside, NY
• Providers in Bayside, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.