Active NPI
Chun-Peng T Chao, MD
- Pediatric Rheumatology Physician
- Hawthorne, NY
National Provider Identifier
1386636645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Rheumatology Physician
- License
- 192592
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01465338 | Medicaid | NY |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 192592 | NY | MD | Pediatric Rheumatology Physician |
Practice roles (2 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boston Childrens Health Physicians LLP | Current | Accepting new patients | |
| Boston Children'S Health Physicians, LLP | Current | 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
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- 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.
-
- Pediatrics Physician
- Hawthorne, NY
- NPI 1467454967
-
- Clinical Medical Laboratory
- Sleepy Hollow, NY
- NPI 1588651079
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.