Individual provider Active NPI

Gloria Hyemin Chung, O.D.

  • Optometrist
  • Whitestone, NY
National Provider Identifier
1184853772
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TRO007449 Issued in NY
Practice address
2003 Utopia Pkwy
Whitestone, NY 11357-4133
Phone
(718) 353-7352
Fax
(718) 423-0930
NPI assigned
Jul 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TRO007449 NY Primary

Addresses

Primary practice location

2003 Utopia Pkwy
Whitestone, NY 11357-4133

Mailing address

2003 Utopia Pkwy
Whitestone, NY 11357-4133
Phone (718) 353-7352

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111021000005 NY Practitioner - Optometry 3072785849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2003 Utopia Pkwy
Whitestone, NY 11357-4133
Phone (718) 353-7352

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TRO007449NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Utopia Optometry PC Optometrist CurrentSince Mar 7, 2024 Accepting new patients

Locations

2003 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 353-7352

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1246752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1184853772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 UTOPIA PKWY",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113574133",
            "telephone_number": "718-353-7352",
            "fax_number": "718-423-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 UTOPIA PKWY",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113574133",
            "telephone_number": "718-353-7352",
            "fax_number": "718-423-0930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "GLORIA",
        "middle_name": "HYEMIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-05",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TRO007449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitestone, NY

Sources for this page

Verify at the official NPI Registry.