Individual provider Active NPI

Grace U Chung, M.D.

  • Dermatology Physician
  • Woodbury, NJ
National Provider Identifier
1235111436
Registry record updated Jul 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
25MA05549000 Issued in NJ
Practice address
17 W. Red Bank Ave
Suite 205
Woodbury, NJ 08096
Phone
(856) 853-0900
Fax
(856) 853-5838
NPI assigned
Nov 15, 2005
Last updated
Jul 11, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 25MA05549000 NJ Primary

Addresses

Primary practice location

17 W. Red Bank Ave
Suite 205
Woodbury, NJ 08096

Mailing address

17 W. Red Bank Ave
Suite 205
Woodbury, NJ 08096
Phone (856) 853-0900

Other identifiers 5

IdentifierTypeStateIssuer
633461OtherNJBLUE SHIELD
197180801MedicaidNJ
24034OtherNJAETNA US HEALTHCARE
0463503000OtherNJAMERIHEALTH
1971808MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20110228000052 NJ Practitioner - Dermatology 0345264156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grace U Chung MD PCGroup PAC ID 5597710707, 5 clinicians

Practice addresses (Care Compare)

500 Grove St
Suite 200
Haddon Heights, NJ 08035-1752
Phone (856) 853-0900

Merit-based Incentive Payment System (MIPS)

Final score
93.06 of 100Reported as group
Quality
96.53
Promoting interoperability
100
Improvement activities
40
Cost
80.34

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision42
Removal of tissue1-10
Removal of skin lesions1410
Removal of skin cancer53
Removal or shaving of skin growth198
Skin biopsy512

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grace U Chung MD PC Dermatology CurrentSince Dec 14, 1990 Accepting new patients

Locations

500 Grove St
Ste 200
Haddon Hgts, NJ 08035
Phone (856) 796-9200

17 W Red Bank Ave
Ste 205
Woodbury, NJ 08096
Phone (856) 853-0900

Organizations & group practices 1

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373500800000",
    "number": "1235111436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 W. RED BANK AVE",
            "address_2": "SUITE 205",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "08096",
            "telephone_number": "856-853-0900",
            "fax_number": "856-853-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 W. RED BANK AVE",
            "address_2": "SUITE 205",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "08096",
            "telephone_number": "856-853-0900",
            "fax_number": "856-853-5838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "GRACE",
        "middle_name": "U",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2013-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MA05549000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "633461",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197180801",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "24034",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0463503000",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1971808",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NJ

Sources for this page

Verify at the official NPI Registry.