Individual provider Active NPI

Doreen E Chung, MD

  • Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
  • New Hyde Park, NY
National Provider Identifier
1215188214
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Urology) PhysicianTaxonomy code 2088F0040X
License
277192 Issued in NY
Practice address
450 Lakeville Rd Ste M41
New Hyde Park, NY 11042-1117
Phone
(516) 734-8500
Fax
(516) 734-8535
NPI assigned
Oct 8, 2008
Last updated
Mar 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 277192 NY
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician 2088F0040X 277192 NY Primary

Addresses

Primary practice location

450 Lakeville Rd Ste M41
New Hyde Park, NY 11042-1117

Mailing address

450 Lakeville Rd Ste M41
New Hyde Park, NY 11042-1117

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150320000422 NY Practitioner - Urology 6709072895 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

450 Lakeville Rd
M41
New Hyde Park, NY 11042-1117
Phone (516) 734-8500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Removal of tissue1-10
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
277192NYMDFemale Pelvic Medicine and Reconstructive Surgery (Urology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Urology CurrentSince Jan 18, 2025 Accepting new patients
Trustees of Columbia University in the City of New York Urology CurrentSince Jan 1, 2018 Accepting new patients
Trustees of Columbia University in Department of Psychiatry CurrentSince Aug 30, 2017 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Dec 1, 2014 Accepting new patients
Trustees of Columbia University in the City of New York Urology CurrentSince Dec 1, 2014 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Manhasset, NY 11030

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

450 Lakeville Rd
Ste M41
New Hyde Park, NY 11042
Phone (516) 734-8567

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

161 Fort Washington Ave
#11
New York, NY 10032
Phone (212) 305-0157

161 Fort Washington Ave
Fl 11
New York, NY 10032
Phone (212) 305-1371

5141 Broadway
New York, NY 10034
Phone (212) 932-4000

5141 Broadway
#3
New York, NY 10034
Phone (212) 932-4165

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: dec9065@direct.nyp.org
  • Direct secure messaging: doreenchung@nslijmedgr.allscriptsdirect.net
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 5

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 4

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": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1215188214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 LAKEVILLE RD STE M41",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 LAKEVILLE RD STE M41",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421117",
            "telephone_number": "516-734-8500",
            "fax_number": "516-734-8535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "DOREEN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-08",
        "last_updated": "2025-03-03",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "277192",
            "primary": false
        },
        {
            "code": "2088F0040X",
            "taxonomy_group": "",
            "desc": "Urology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "NY",
            "license": "277192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.