Individual provider Active NPI

Paul Tchao, MD

  • Internal Medicine Physician
  • Deer Park, NY
National Provider Identifier
1346286796
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
130686 Issued in NY
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

Updated by the provider on Apr 4, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050615000804 NY Practitioner - Internal MedicinePractitioner - Family Practice 4789628298 Practice locations: Deer Park, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
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

LicenseStateTypeSpecialty
130686NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew 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

Verify at the official NPI Registry.