Individual provider Active NPI

Andy Tuan Anh Chung, MD

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Corsicana, TX
National Provider Identifier
1164449666
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
N2033 Issued in TX
Practice address
400 Hospital Dr Ste 100
Corsicana, TX 75110-2489
Phone
(903) 641-4270
Fax
(903) 875-1515
NPI assigned
Jul 17, 2006
Last updated
Sep 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X 2004034263 MO
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X N2033 TX Primary

Addresses

Primary practice location

400 Hospital Dr Ste 100
Corsicana, TX 75110-2489

Mailing address

PO Box 689022
Franklin, TN 37068-9022
Phone (615) 465-7385

Other practice location 1

7777 Forest Ln.
Suite B432
Dallas, TX 75230-2576
Phone (972) 566-8300

Other identifiers 2

IdentifierTypeStateIssuer
017257OtherCOKAISER COMMERCIAL
76480330MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20090626000520 TX Practitioner - Otolaryngology 8921041260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Loma Linda University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

400 Hospital Dr
Suite 100
Corsicana, TX 75110-2489
Phone (903) 654-4565

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.18 of 100Reported as apm
Quality
71.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2004034263MOMDPlastic Surgery within the Head & Neck (Otolaryngology) Physician
N2033TXMDPlastic Surgery within the Head & Neck (Otolaryngology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Employee Assistance Program Inc CurrentSince Sep 5, 2022 Accepting new patients
Regional Employee Assistance Program Inc CurrentSince Sep 5, 2022 Accepting new patients
Regional Employee Assistance Program Inc Current Accepting new patients

Locations

3201 W State Highway 22
Corsicana, TX 75110
Phone (903) 654-6800

400 Hospital Dr
Ste 100
Corsicana, TX 75110
Phone (903) 641-3830

Interoperability endpoints

  • Direct secure messaging: andy.chung.1@1902.direct.athenahealth.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.

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1164449666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689022",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370689022",
            "telephone_number": "615-465-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HOSPITAL DR STE 100",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751102489",
            "telephone_number": "903-641-4270",
            "fax_number": "903-875-1515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7777 Forest Ln.",
            "address_2": "Suite B432",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752302576",
            "country_code": "US",
            "telephone_number": "972-566-8300",
            "fax_number": "972-566-8004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "ANDY",
        "middle_name": "TUAN ANH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "MO",
            "license": "2004034263",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "TX",
            "license": "N2033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL",
            "identifier": "017257",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "76480330",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corsicana, TX

Sources for this page

Verify at the official NPI Registry.