Individual provider Active NPI

Joselita Chua, M.D.

  • Psychiatry Physician
  • Lakewood, OH
National Provider Identifier
1225175193
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35080538 Issued in OH
Practice address
12500 Edgewater Dr
#1402
Lakewood, OH 44107-1677
Phone
(216) 227-1199
NPI assigned
Jan 31, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35080538 OH Primary
Psychiatry Physician 2084P0800X A88164 CA

Addresses

Primary practice location

12500 Edgewater Dr
#1402
Lakewood, OH 44107-1677

Mailing address

12500 Edgewater Dr
#1402
Lakewood, OH 44107-1677
Phone (216) 227-1199

Other identifiers 2

IdentifierTypeStateIssuer
35080538OtherOHLICENSE
A88164OtherCALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150716000402 CA Practitioner - Psychiatry 8820057664 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A88164CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Services CurrentSince Mar 20, 2022 Accepting new patients
San Joaquin Behavioral Health Services Current Accepting new patients
San Joaquin County Public Health Services CurrentSince Apr 1, 2014 Accepting new patients
County of San Joaquin CurrentSince Apr 1, 2014 Accepting new patients
County of Santa Clara CurrentSince Sep 15, 2018 Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince Dec 10, 2016 Accepting new patients
County of Santa Clara Psychiatry CurrentSince Sep 15, 2018 Accepting new patients
County of Santa Clara CurrentSince Dec 10, 2016 Accepting new patients
County of Santa Clara Psychiatry Current Accepting new patients
Bridgeway,Inc Past Accepting new patients

Locations

1075 E Santa Clara St
San Jose, CA 95116
Phone (408) 299-6175

1555 Parkmoor Ave
San Jose, CA 95128
Phone (408) 282-0402

1650 Las Plumas Ave
Ste K
San Jose, CA 95133
Phone (408) 272-6726

1887 Monterey Hwy
Ste 205
San Jose, CA 95112
Phone (408) 494-1561

2221 Enborg Ln
San Jose, CA 95128
Phone (408) 885-6220

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

820 Enborg Ct
San Jose, CA 95128
Phone (408) 207-3138

1212 N California St
Stockton, CA 95202
Phone (209) 468-8660

Interoperability endpoints

  • Direct secure messaging: jchua85129@santaclaravalley.direct-ci.net

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1225175193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12500 EDGEWATER DR",
            "address_2": "#1402",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441071677",
            "telephone_number": "216-227-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12500 EDGEWATER DR",
            "address_2": "#1402",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441071677",
            "telephone_number": "216-227-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUA",
        "first_name": "JOSELITA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35080538",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A88164",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "35080538",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A88164",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, OH

Sources for this page

Verify at the official NPI Registry.