Active NPI
Sungsil Cho, MD
- Family Medicine Physician
- Mystic, CT
National Provider Identifier
1437611696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 72263
- Practice address
- 23 Clara Dr
Mystic, CT 06355-1959 - Phone
- (860) 572-5782
- NPI assigned
- Apr 4, 2019
- Last updated
- Nov 28, 2022
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 72263 | CT | Primary |
Addresses
Primary practice location
23 Clara Dr
Mystic, CT 06355-1959
Mailing address
99 Hawley LN FL 3
Stratford, CT 06614-1202
Phone (860) 572-5782
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437611696 | Medicaid | RI | |
| 1437611696 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ptsma Inc
Practice addresses (Care Compare)
23 Clara Dr
Mystic, CT 06355-1959
Phone (860) 572-5782
37 S Broad St
Unit 12
Pawcatuck, CT 06379-7909
Phone (860) 495-1919
Hospital & facility affiliations
- Yale New Haven Health - Health at Home Southeast
- Hartford Healthcare at Home
- Lawrence & Memorial Hospital
- Westerly Hospital
- Yale-New Haven Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 86.54
- Promoting interoperability
- 99.98
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 72263 | CT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Medical Group, Inc. | Current | Accepting new patients |
Locations
23 Clara Dr
Mystic, CT 06355
Phone (860) 443-7907
95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388
Interoperability endpoints
- scho585413@direct.ynhh.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Bridgeport, CT
- NPI 1043278351
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Wethersfield, CT
- NPI 1073529566
-
dba Lawrence and Memorial Hospital
- General Acute Care Hospital
- New London, CT
- NPI 1073530879
-
dba Lawrence and Memorial Hospital
- General Acute Care Hospital
- New London, CT
- NPI 1700092459
-
- Home Health Agency
- Waterford, CT
- NPI 1265490940
-
- General Acute Care Hospital
- New Haven, CT
- NPI 1336139500
-
- General Acute Care Hospital
- New Haven, CT
- NPI 1578778726
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669593600000",
"number": "1437611696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 HAWLEY LN FL 3",
"city": "STRATFORD",
"state": "CT",
"postal_code": "066141202",
"telephone_number": "860-572-5782"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 CLARA DR",
"city": "MYSTIC",
"state": "CT",
"postal_code": "063551959",
"telephone_number": "860-572-5782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHO",
"first_name": "SUNGSIL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-04",
"last_updated": "2022-11-28",
"certification_date": "2022-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CT",
"license": "72263",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1437611696",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1437611696",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mystic, CT
- Curt Ira Cheslog, PT, MSPT, OCS
- Child and Family Agency of Southeastern Connecticut Inc.
- Child and Family Agency of Southeastern Connecticut, Inc. (Mystic River Magnet School)
- Child and Family Agency of Southeastern Connecticut, Inc.
- Child and Family Agency of Southeastern Connecticut, Inc.
- Katieanne P Christian, DPT
- Christopher Level Inc (Level Chiropractic)
- Kathrine Lynn Clarke, LMFT
- Jeannine Cleaver, LCSW
- Coastal Chiropractic & Family Wellness Centre
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.