Individual provider Active NPI

Chun-Peng T Chao, MD

  • Pediatric Rheumatology Physician
  • Hawthorne, NY
National Provider Identifier
1386636645
Registry record updated Jul 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rheumatology PhysicianTaxonomy code 2080P0216X
License
192592 Issued in NY
Practice address
19 Bradhurst Ave
Ste. 1400
Hawthorne, NY 10532-2140
Phone
(914) 594-4835
Fax
(914) 594-4762
NPI assigned
Aug 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Rheumatology Physician 2080P0216X 192592 NY Primary

Addresses

Primary practice location

19 Bradhurst Ave
Ste. 1400
Hawthorne, NY 10532-2140

Mailing address

22 Saw Mill River Rd
2ND Floor
Hawthorne, NY 10532-1533
Phone (914) 594-4835

Other identifiers 1

IdentifierTypeStateIssuer
01465338MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20071016000138 NY Practitioner - RheumatologyPractitioner - Pediatric Medicine 7113013566 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
192592NYMDPediatric Rheumatology Physician

Practice roles (2 of 6)

OrganizationSpecialtyStatusNew patients
Boston Childrens Health Physicians LLP CurrentSince Jan 1, 2014 Accepting new patients
Boston Children'S Health Physicians, LLP CurrentSince Jan 1, 2014 Accepting new patients

Locations

22 Saw Mill River Rd
Ste 2
Hawthorne, NY 10532
Phone (914) 593-1606

19 Bradhurst Ave
Ste 1400
Hawthorne, NY 10532
Phone (914) 493-7997

19 Bradhurst Ave
Hawthorne, NY 10532
Phone (914) 493-7235

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: chunpeng.chao.p1@direct.cwpw.nextgenshare.com

Organizations & group practices 2

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": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374451200000",
    "number": "1386636645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 SAW MILL RIVER RD",
            "address_2": "2ND FLOOR",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105321533",
            "telephone_number": "914-594-4835",
            "fax_number": "914-594-4762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE",
            "address_2": "STE. 1400",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140",
            "telephone_number": "914-594-4835",
            "fax_number": "914-594-4762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAO",
        "first_name": "CHUN-PENG",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-22",
        "last_updated": "2013-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "NY",
            "license": "192592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01465338",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, NY

Sources for this page

Verify at the official NPI Registry.