NPIMap

Individual provider Active NPI

Michael Taehoon Chung, DPM

  • Foot Surgery Podiatrist
  • Virginia Beach, VA
National Provider Identifier
1164416681
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
0103300727 Issued in VA
Practice address
5253 Providence Rd Ste 100
Virginia Beach, VA 23464-4201
Phone
(757) 252-4640
Fax
(757) 510-9343
NPI assigned
Sep 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 0103300727 VA Primary

Addresses

Primary practice location

5253 Providence Rd Ste 100
Virginia Beach, VA 23464-4201

Mailing address

5253 Providence Rd Ste 100
Virginia Beach, VA 23464-4201
Phone (757) 252-4640

Other identifiers 1

IdentifierTypeStateIssuer
9304894MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100210000581 VA Practitioner - Podiatry 0547303729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

844 Kempsville Rd
Suite 104
Norfolk, VA 23502-3927
Phone (757) 252-5600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue94
Removal of skin lesions36
Removal of nail tissue56

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Mar 1, 2011 Accepting new patients
Podiatry LTD Foot Surgery PastSince Jul 1, 1992 Accepting new patients
Seva Foot and Ankle Center Foot Surgery PastSince Jun 23, 2018 Accepting new patients
Lehigh Valley Bone Muscle and Joint Past Accepting new patients
Robert W Sullivan DPM PC PastSince Sep 8, 2003 Accepting new patients
Virginia Podiatry PC Foot Surgery Past Accepting new patients

Locations

844 Kempsville Rd
Ste 104
Norfolk, VA 23502
Phone (757) 252-5600

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

5253 Providence Rd
Ste 100
Virginia Beach, VA 23464
Phone (757) 252-4640

5253 Providence Rd
#100
Virginia Beach, VA 23464
Phone (757) 495-6113

Interoperability endpoints

  • Direct secure messaging: mchung23658@direct.sentara.net
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 6

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 6

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": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1164416681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5253 PROVIDENCE RD STE 100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644201",
            "telephone_number": "757-252-4640",
            "fax_number": "757-510-9343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5253 PROVIDENCE RD STE 100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644201",
            "telephone_number": "757-252-4640",
            "fax_number": "757-510-9343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "MICHAEL",
        "middle_name": "TAEHOON",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "VA",
            "license": "0103300727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9304894",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.