Individual provider Active NPI

Thomas Sin Young Chung, FNP-C

  • Nurse Practitioner
  • Palm Springs, CA
National Provider Identifier
1114378171
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95004655 Issued in CA
Practice address
255 N El Cielo Rd Ste C-326
Palm Springs, CA 92262-6992
Phone
(760) 969-6535
NPI assigned
Jun 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95004655 CA Primary

Addresses

Primary practice location

255 N El Cielo Rd Ste C-326
Palm Springs, CA 92262-6992

Mailing address

255 N El Cielo Rd Ste C-326
Palm Springs, CA 92262-6992
Phone (760) 969-6535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20161012000565 CA Practitioner - Nurse Practitioner 9638467384 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Desert Medical Group IncGroup PAC ID 8123930427, 71 clinicians

Practice addresses (Care Compare)

275 N El Cielo Rd
Palm Springs, CA 92262-6972
Phone (760) 323-8657

Merit-based Incentive Payment System (MIPS)

Final score
96.75 of 100Reported as group
Quality
82.33
Improvement activities
40
Cost
79.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Medical Group, Inc. CurrentSince Jan 11, 2024 Accepting new patients
Inland Empire Cardiovascular Consultants, Inc. CurrentSince Sep 1, 2016 Accepting new patients
Desert Nephrology PastSince Apr 28, 2024 Accepting new patients

Locations

255 N El Cielo Rd
Ste C326
Palm Springs, CA 92262
Phone (760) 969-6535

275 N El Cielo Rd
Palm Springs, CA 92262
Phone (760) 320-8814

6950 Brockton Ave
Ste 1
Riverside, CA 92506
Phone (909) 883-8938

399 E Highland Ave
Ste 307
Sn Bernrdno, CA 92404
Phone (909) 881-7400

Interoperability endpoints

  • Direct secure messaging: thomas.chung.p2@direct.mydohc.nextgenshare.com

Organizations & group practices 3

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": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1114378171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 N EL CIELO RD STE C-326",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922626992",
            "telephone_number": "760-969-6535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N EL CIELO RD STE C-326",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922626992",
            "telephone_number": "760-969-6535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "THOMAS",
        "middle_name": "SIN YOUNG",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-30",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95004655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

Verify at the official NPI Registry.