NPIMap

Individual provider Active NPI

Theodore J Chu, M.D.

  • Allergy Physician
  • San Jose, CA
National Provider Identifier
1194765123
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
G12838 Issued in CA
Practice address
130 Bellerose Dr
San Jose, CA 95128-1729
Phone
(408) 816-8923
Fax
(669) 242-7914
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology (Internal Medicine) Physician 207RA0201X G12838 CA
Allergy Physician 207KA0200X G12838 CA Primary

Addresses

Primary practice location

130 Bellerose Dr
San Jose, CA 95128-1729

Mailing address

130 Bellerose Dr
San Jose, CA 95128-1729
Phone (408) 816-8923

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050705000702 CA Practitioner - Allergy/ImmunologyPractitioner - OtolaryngologyPractitioner - Internal Medicine 3476524851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine
Education
Yale University School of Medicine, 1963
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

130 Bellerose Dr
San Jose, CA 95128-1729
Phone (408) 816-8923

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G12838CAMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital of Suffern Past Accepting new patients
County of Santa Clara Past Accepting new patients
El Camino Hospital Past Accepting new patients
El Camino Hospital Past Accepting new patients
LPCH Medical Group Div of Lucile Past Accepting new patients
Lucile Salter Packard Children's Hospital at Stanford Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 9

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1194765123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 BELLEROSE DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281729",
            "telephone_number": "408-816-8923",
            "fax_number": "669-242-7914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 BELLEROSE DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281729",
            "telephone_number": "408-816-8923",
            "fax_number": "669-242-7914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHU",
        "first_name": "THEODORE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0201X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "CA",
            "license": "G12838",
            "primary": false
        },
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "CA",
            "license": "G12838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.