Individual provider Active NPI

Martha A Chong, M.D.

  • Pediatrics Physician
  • Riverside, CA
National Provider Identifier
1245243815
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A72474 Issued in CA
Practice address
9415 Mission Blvd
Riverside, CA 92509-2600
Phone
(951) 360-8795
Fax
(951) 360-8798
NPI assigned
Aug 14, 2006
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A72474 CA Primary

Addresses

Primary practice location

9415 Mission Blvd
Riverside, CA 92509-2600

Mailing address

PO Box 7849
Riverside, CA 92513-7849
Phone (951) 358-5222

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
I20141016000192 CA Practitioner - Pediatric Medicine 1951522952 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A72474CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Riverside Current Accepting new patients
County of Riverside CurrentSince Jan 27, 2024 Accepting new patients

Locations

308 E San Jacinto Ave
Perris, CA 92570
Phone (951) 940-6700

7140 Indiana Ave
Riverside, CA 92504
Phone (909) 358-6035

Interoperability endpoints

  • Direct secure messaging: mchong96840@direct.llu.edu

Organizations & group practices 2

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1245243815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7849",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925137849",
            "telephone_number": "951-358-5222",
            "fax_number": "951-358-5235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9415 MISSION BLVD",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925092600",
            "telephone_number": "951-360-8795",
            "fax_number": "951-360-8798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHONG",
        "first_name": "MARTHA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A72474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.