NPIMap

Individual provider Active NPI

Wincha Chong, MD

  • Diagnostic Radiology Physician
  • Troy, OH
National Provider Identifier
1205845906
Registry record updated Feb 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
35094025 Issued in OH
Practice address
3130 N Dixie Hwy
Troy, OH 45373-1337
Phone
(937) 440-4896
Fax
(937) 440-4381
NPI assigned
Aug 5, 2006
Last updated
Feb 24, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2006018664 MO
Diagnostic Radiology Physician 2085R0202X 35094025 OH Primary

Addresses

Primary practice location

3130 N Dixie Hwy
Troy, OH 45373-1337

Mailing address

2591 Miamisburg Centerville Road
Suite 302
Dayton, OH 45459-3706
Phone (937) 433-7622

Other identifiers 2

IdentifierTypeStateIssuer
2990018MedicaidOH
4272171OtherOHMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20091002000110 OH Practitioner - Diagnostic Radiology 4789689829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Washington University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Radiology and Interventional Associates IncGroup PAC ID 8729976964, 251 clinicians

Practice addresses (Care Compare)

610 W Main St
Clinton Memorial Hospital
Wilmington, OH 45177-2194
Phone (800) 803-9648

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35094025OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Radiology and Interventional Associates Inc Diagnostic Radiology CurrentSince Oct 1, 2019 Accepting new patients
Carelife Imaging, LLC CurrentSince Sep 1, 2021 Accepting new patients
Maryville Radiology Group, LTD Diagnostic Radiology PastSince Feb 16, 2020 Accepting new patients

Locations

3535 Olentangy River Rd
Columbus, OH 43214
Phone (614) 566-1997

915 Michigan St
Sidney, OH 45365
Phone (937) 498-2311

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 7

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298505600000",
    "number": "1205845906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2591 MIAMISBURG CENTERVILLE ROAD",
            "address_2": "SUITE 302",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454593706",
            "telephone_number": "937-433-7622",
            "fax_number": "937-433-7656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 N DIXIE HWY",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453731337",
            "telephone_number": "937-440-4896",
            "fax_number": "937-440-4381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHONG",
        "first_name": "WINCHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2011-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2006018664",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35094025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2990018",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "4272171",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, OH

Sources for this page

Verify at the official NPI Registry.