NPIMap

Individual provider Active NPI

Kye Im Chong, MD

  • Family Medicine Physician
  • St. Augustine, FL
National Provider Identifier
1376736355
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME106337 Issued in FL
Practice address
230 Village Commons Drive
St. Augustine, FL 32092
Phone
(904) 940-1441
Fax
(904) 390-7463
NPI assigned
Aug 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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 001929 GA
Family Medicine Physician 207Q00000X ME106337 FL Primary

Addresses

Primary practice location

230 Village Commons Drive
St. Augustine, FL 32092

Mailing address

PO Box 746638
Atlanta, GA 30374-6638
Phone (904) 202-1032

Other practice location 1

141 Hilden Rd Ste 201
Ponte Vedra, FL 32081-8400
Phone (904) 825-1941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100528000485 FL Practitioner - Family Practice 9032248059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Primary Care IncGroup PAC ID 0648177733, 459 clinicians

Practice addresses (Care Compare)

141 Hilden Rd
Suite 201
Ponte Vedra, FL 32081-8400
Phone (904) 825-1941

Hospital & facility affiliations

  • Baptist Home Health Care by Bayada Home health agency, Jacksonville, FL, CCN 107482
  • Brooks Rehabilitation Home Health Home health agency, Jacksonville, FL, CCN 103174
  • A Care Connection Home Health Home health agency, Jacksonville, FL, CCN 109709
  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
  • Flagler Hospital Hospital, Saint Augustine, FL, CCN 100090
  • Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
  • Brooks Rehabilitation Hospital University Campus Inpatient rehabilitation facility, Jacksonville, FL, CCN 103039
  • Westminster St Augustine Nursing home, Saint Augustine, FL, CCN 106040

Merit-based Incentive Payment System (MIPS)

Final score
95.44 of 100Reported as apm
Quality
84.21
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions25
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001929GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Primary Care Inc Family Medicine CurrentSince Oct 1, 2022 Accepting new patients
Baptist Primary Care Inc Family Medicine CurrentSince Oct 1, 2022 Accepting new patients
Baptist Primary Care Inc Family Medicine Current Accepting new patients

Locations

836 Prudential Dr
Ste 1207
Jacksonville, FL 32207
Phone (904) 396-8656

141 Hilden Rd
Ste 201
Ponte Vedra, FL 32081
Phone (904) 825-1941

230 Village Commons Dr
Saint Augustine, FL 32092
Phone (904) 940-1441

Interoperability endpoints

  • Direct secure messaging: kchong741098@direct.shands.ufl.edu
  • Direct secure messaging: kchong124189@baptisthealthsystemjacksonville.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 10

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": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1376736355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746638",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746638",
            "telephone_number": "904-202-1032",
            "fax_number": "904-376-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 VILLAGE COMMONS DRIVE",
            "city": "ST. AUGUSTINE",
            "state": "FL",
            "postal_code": "32092",
            "telephone_number": "904-940-1441",
            "fax_number": "904-390-7463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "141 Hilden Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Ponte Vedra",
            "state": "FL",
            "postal_code": "320818400",
            "country_code": "US",
            "telephone_number": "904-825-1941",
            "fax_number": "904-391-7460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHONG",
        "first_name": "KYE",
        "middle_name": "IM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "001929",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME106337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Augustine, FL

Sources for this page

Verify at the official NPI Registry.