Individual provider Active NPI

Maurice Wendell Chung, M.D.

  • Gastroenterology Physician
  • Milwaukee, WI
National Provider Identifier
1124042015
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
26944 Issued in WI
Practice address
2311 N Prospect Ave
Milwaukee, WI 53211-4445
Phone
(414) 319-3000
Fax
(414) 319-3033
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 26944 WI Primary

Addresses

Primary practice location

2311 N Prospect Ave
Milwaukee, WI 53211-4445

Mailing address

4425 N Port Washington Rd
Attn: Csmcp Clinic Credentialing
Glendale, WI 53212-1082
Phone (414) 319-3000

Other identifiers 1

IdentifierTypeStateIssuer
30743100MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20060201000487 WI Practitioner - GastroenterologyPractitioner - Internal Medicine 4385636810 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Medical College of Wisconsin, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia St Marys Hospital Milwaukee IncGroup PAC ID 5890604722, 311 clinicians
Ascension Medical Group-Southeast Wisconsin IncGroup PAC ID 8628980943, 551 clinicians

Practice addresses (Care Compare)

13111 N Port Washington Rd
Mequon, WI 53097-2416
Phone (262) 243-7300

201 N Mayfair Rd
Wauwatosa, WI 53226-4216

2301 N Lake Dr
Milwaukee, WI 53211-4508

2311 N Prospect Ave
Milwaukee, WI 53211-4445
Phone (414) 319-3000

2323 N Lake Dr
Milwaukee, WI 53211-4508
Phone (414) 585-1000

375 W Riverwoods Pkwy
Glendale, WI 53212-1080
Phone (414) 326-1800

801 S 70TH St
West Allis, WI 53214-3147
Phone (414) 773-6600

9252 N Green Bay Rd
Brown Deer, WI 53209-1104
Phone (414) 527-7500

Hospital & facility affiliations

  • Ascension Columbia St Marys Hospital Milwaukee Hospital, Milwaukee, WI, CCN 520051

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy47
Upper gastrointestinal (GI) endoscopy for acid reflux49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26944WIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Jul 23, 2021 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Dec 1, 2007 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc CurrentSince Dec 1, 2007 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Past Accepting new patients
Maurice W. Chung, M.D., S.C. Gastroenterology PastSince Feb 15, 1999 Accepting new patients

Locations

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

375 W River Woods Pkwy
Glendale, WI 53212
Phone (414) 326-1500

2311 N Prospect Ave
Milwaukee, WI 53211
Phone (414) 319-3000

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1124042015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 N PORT WASHINGTON RD",
            "address_2": "ATTN: CSMCP CLINIC CREDENTIALING",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121082",
            "telephone_number": "414-319-3000",
            "fax_number": "414-319-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 N PROSPECT AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114445",
            "telephone_number": "414-319-3000",
            "fax_number": "414-319-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "MAURICE",
        "middle_name": "WENDELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WI",
            "license": "26944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30743100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.