Individual provider Active NPI

Johnson Chiu, MD

  • Hospitalist Physician
  • Orange, CA
National Provider Identifier
1356412241
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
A87164 Issued in CA
Practice address
1310 W Stewart Dr
Suite 410
Orange, CA 92868-3854
Phone
(714) 639-9401
Fax
(714) 639-4105
NPI assigned
Nov 13, 2006
Last updated
Oct 21, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A87164 CA
Hospitalist Physician 208M00000X A87164 CA Primary

Addresses

Primary practice location

1310 W Stewart Dr
Suite 410
Orange, CA 92868-3854

Mailing address

1310 W Stewart Dr
Suite 410
Orange, CA 92868-3854
Phone (714) 639-9401

Other identifiers 6

IdentifierTypeStateIssuer
00A871640MedicaidCA
1912919804OtherNPI - TYPE 2
GR0003350OtherCAMEDICAID - GROUP PROVIDER
W1514OtherCAMEDICARE PTAN - TYPE 2
P00734040OtherCARAIL ROAD MEDICARE - PROVIDER PTAN
CG5665OtherCARAIL ROAD MEDICARE - GROUP PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address johnson.chiu@direct.stjoe.org

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
I20050110000674 CA Practitioner - Internal MedicinePractitioner - Hospitalist 4981652682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Saint Louis University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1100 W Stewart Dr
Orange, CA 92868-3849
Phone (714) 633-9111

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

200 W Ctr St Promenade
Anaheim, CA 92805-3960

845 W la Veta Ave
Orange, CA 92868-3930

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A87164CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Nov 29, 2014 Accepting new patients
Providence Medical Foundation CurrentSince Nov 29, 2014 Accepting new patients
Orange Orthopedic Medica GP, Inc. the Providence BLDG PastSince Nov 1, 2008 Accepting new patients
Southern California Hospitalist Network Medical Group Inc Internal Medicine Past Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1356412241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 W STEWART DR",
            "address_2": "SUITE 410",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683854",
            "telephone_number": "714-639-9401",
            "fax_number": "714-639-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 W STEWART DR",
            "address_2": "SUITE 410",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683854",
            "telephone_number": "714-639-9401",
            "fax_number": "714-639-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIU",
        "first_name": "JOHNSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A87164",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A87164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A871640",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI - TYPE 2",
            "identifier": "1912919804",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID - GROUP PROVIDER",
            "identifier": "GR0003350",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN - TYPE 2",
            "identifier": "W1514",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE - PROVIDER PTAN",
            "identifier": "P00734040",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE - GROUP PTAN",
            "identifier": "CG5665",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "johnson.chiu@direct.stjoe.org",
            "affiliation": "N",
            "address_1": "1310 W Stewart Dr",
            "address_2": "Suite 410",
            "city": "Orange",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928683854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.