Active NPI
Jae Chung, M.D.
- Medical Oncology Physician
- Port Charlotte, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Oncology Physician
- License
- ME150694
- Practice address
- 22395 Edgewater Dr
Port Charlotte, FL 33980-2012 - Phone
- (941) 766-7222
- Fax
- (941) 766-0970
- NPI assigned
- Apr 13, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Oncology Physician | 207RX0202X | ME150694 | FL | Primary |
| Internal Medicine Physician | 207R00000X | ME150694 | FL | |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
22395 Edgewater Dr
Port Charlotte, FL 33980-2012
Mailing address
PO Box 102222
Atlanta, GA 30368-2222
Phone (239) 274-8200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111271700 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- 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 |
|---|---|---|---|---|
| I20210722001987 | FL | Practitioner - Hematology/Oncology | 8123320140 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Hematology/Oncology
- Education
- University of South Florida College of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Florida Cancer Specialists and Research Institute, LLC
Practice addresses (Care Compare)
22395 Edgewater Dr
Florida Cancer Specialists P L
Port Charlotte, FL 33980-2012
Phone (941) 766-7222
Hospital & facility affiliations
- HCA Florida Fawcett Hospital
- Adventhealth Port Charlotte
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME150694 | FL | MD | Medical Oncology Physician |
Practice roles (1 of 3)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Cancer Specialists & Research Institute, LLC | Medical Oncology | Current | Accepting new patients |
Locations
4371 Veronica S Shoemaker Blvd
Fort Myers, FL 33916
Phone (239) 432-8500
22395 Edgewater Dr
Fl Cancer
Port Charlotte, FL 33980
Phone (941) 766-7222
22395 Edgewater Dr
Pt Charlotte, FL 33980
Phone (941) 766-7222
1970 Golf St
Fl Cancer
Sarasota, FL 34236
Phone (941) 795-3780
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
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 and National Provider Directory roles.
-
- Medical Oncology Physician
- Cape Coral, FL
- NPI 1760590962
FL, Medical Oncology
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Port Charlotte, FL
- NPI 1760299093
Hospital
-
- General Acute Care Hospital
- Port Charlotte, FL
- NPI 1417901406
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770595200000",
"number": "1346636636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 102222",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303682222",
"telephone_number": "239-274-8200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22395 EDGEWATER DR",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339802012",
"telephone_number": "941-766-7222",
"fax_number": "941-766-0970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUNG",
"first_name": "JAE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-13",
"last_updated": "2026-02-09",
"certification_date": "2026-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "207RX0202X",
"taxonomy_group": "",
"desc": "Internal Medicine, Medical Oncology",
"state": "FL",
"license": "ME150694",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME150694",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "111271700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Port Charlotte, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2026; 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.