Active NPI
Paul Tchao, MD
- Internal Medicine Physician
- Deer Park, NY
National Provider Identifier
1346286796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 130686
- Practice address
- 2043 Deer Park Ave
Deer Park, NY 11729 - Phone
- (631) 242-8488
- Fax
- (631) 274-3505
- NPI assigned
- Jun 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 130686 | NY | |
| Internal Medicine Physician | 207R00000X | 130686 | NY | Primary |
Addresses
Primary practice location
2043 Deer Park Ave
Deer Park, NY 11729
Mailing address
2043 Deer Park Ave
Deer Park, NY 11729
Phone (631) 242-8488
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050615000804 | NY | Practitioner - Internal Medicine | 4789628298 | Practice locations: Deer Park, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
2043 Deer Park Ave
Deer Park, NY 11729-2110
Phone (651) 242-8488
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 130686 | NY | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Preventive Medical Care PC | Family Medicine | Past | Accepting new patients |
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": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207267200000",
"number": "1346286796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2043 DEER PARK AVE",
"city": "DEER PARK",
"state": "NY",
"postal_code": "11729",
"telephone_number": "631-242-8488",
"fax_number": "631-274-3505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2043 DEER PARK AVE",
"city": "DEER PARK",
"state": "NY",
"postal_code": "11729",
"telephone_number": "631-242-8488",
"fax_number": "631-274-3505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TCHAO",
"first_name": "PAUL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-22",
"last_updated": "2008-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "130686",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "130686",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Deer Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.