Individual provider Active NPI

Chan Dong Cho, LAC

  • Acupuncturist
  • Flushing, NY
National Provider Identifier
1356625271
Registry record updated Apr 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
000606-1 Issued in NY
Practice address
14737 41St Ave
Flushing, NY 11355-1248
Phone
(718) 358-8378
NPI assigned
Oct 11, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 000606-1 NY Primary

Addresses

Primary practice location

14737 41St Ave
Flushing, NY 11355-1248

Mailing address

14737 41St Ave
Flushing, NY 11355-1248
Phone (718) 358-8378

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000606NYMDBehavioral Analyst
000606-1NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Jaesae Acupuncture PC Acupuncturist CurrentSince Feb 19, 2023 Accepting new patients

Locations

14737 41st Ave
Flushing, NY 11355
Phone (718) 358-8378

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.

NPI Registry JSON

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

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429660800000",
    "number": "1356625271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14737 41ST AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113551248",
            "telephone_number": "718-358-8378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14737 41ST AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113551248",
            "telephone_number": "718-358-8378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHO",
        "first_name": "CHAN",
        "middle_name": "DONG",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-11",
        "last_updated": "2015-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "000606-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.