Individual provider Active NPI

Roy Chong

  • Nurse Practitioner
  • Anaheim, CA
National Provider Identifier
1386330389
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95030711 Issued in CA
Practice address
511 N Brookhurst St Ste 200
Anaheim, CA 92801-5229
Phone
(714) 780-0750
NPI assigned
Apr 12, 2023
Last updated
Oct 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95030711 CA Primary

Addresses

Primary practice location

511 N Brookhurst St Ste 200
Anaheim, CA 92801-5229

Mailing address

8612 Whittle CT
Downey, CA 90240-3979

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251009003422 CA Practitioner - Nurse Practitioner 7810494317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
College Community ServicesGroup PAC ID 4183767999, 8 clinicians

Practice addresses (Care Compare)

511 N Brookhurst St
Suite 200
Anaheim, CA 92801-5229
Phone (714) 780-0750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95030711CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
College Community Services Current Accepting new patients
College Community Services CurrentSince Jul 26, 2025 Accepting new patients
College Community Services CurrentSince Jul 26, 2025 Accepting new patients

Locations

511 N Brookhurst St
Ste 200
Anaheim, CA 92801
Phone (714) 780-0750

1855 W Katella Ave
Ste 150
Orange, CA 92867
Phone (714) 399-3480

8337 Telegraph Rd
Ste 300
Pico Rivera, CA 90660
Phone (562) 207-4272

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, 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": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1386330389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8612 WHITTLE CT",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902403979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 N BROOKHURST ST STE 200",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928015229",
            "telephone_number": "714-780-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHONG",
        "first_name": "ROY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-12",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95030711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.