Organization Active NPI

Sandy Cheung, DO, PLLC

  • Medical Specialty Clinic/Center
  • New York, NY
National Provider Identifier
1225324015
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
247111 Issued in NY
Legal business name
SANDY CHEUNG, DO, PLLC
Practice address
11 E Broadway Ste 11B
New York, NY 10038-1013
Phone
(212) 966-9886
Fax
(212) 966-9868
NPI assigned
Jun 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2021

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

Authorized official

Name
Sandy CheungNPI 1659533776
Title
Physician
Phone
(212) 966-9886

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 247111 NY Primary

Addresses

Primary practice location

11 E Broadway Ste 11B
New York, NY 10038-1013

Mailing address

11 E Broadway Ste 11B
New York, NY 10038-1013
Phone (212) 966-9886

Other practice location 1

18 East Broadway
Suite 503
New York, NY 10002
Phone (212) 966-9886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110622000203 NY Part B Supplier - Clinic/Group Practice 1557549565 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2026441Sandy Cheung, DO, PLLC11 East Broadway, Suite 11 B, New York, NY 10038Certificate of waiverJun 29, 2027

National Provider Directory

National Provider Directory

Locations

11 E Broadway
Ste 11B
New York, NY 10038
Phone (212) 966-9886

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622073600000",
    "number": "1225324015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 E BROADWAY STE 11B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100381013",
            "telephone_number": "212-966-9886",
            "fax_number": "212-966-9868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 E BROADWAY STE 11B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100381013",
            "telephone_number": "212-966-9886",
            "fax_number": "212-966-9868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18 East Broadway",
            "address_2": "Suite 503",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10002",
            "country_code": "US",
            "telephone_number": "212-966-9886",
            "fax_number": "212-966-9868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SANDY CHEUNG, DO, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-21",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A",
        "authorized_official_last_name": "CHEUNG",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "212-966-9886"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "247111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.