Chong H Park, M.D., F.R.C.S.(US)

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

25MA04390700 Issued in NJ

Practice address

775 Bloomfield Ave
Montclair, NJ 07042-1880

Phone

(973) 509-3401

Fax

(973) 655-1560

NPI assigned

Dec 28, 2006

Last updated

Mar 29, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

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.

• Wees Physical Therapy and Wellness Clinic

  dba wees health care clinic

  • Physical Therapist
  • Fort Lee, NJ
  • NPI 1043385941
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364515200000",
    "number": "1457417180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 BLOOMFIELD AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070421880",
            "telephone_number": "973-509-3401",
            "fax_number": "973-655-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 BLOOMFIELD AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070421880",
            "telephone_number": "973-509-3401",
            "fax_number": "973-655-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CHONG",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D., F.R.C.S.(US)",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2013-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NJ",
            "license": "25MA04390700",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NJ",
            "license": "25MA04390700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George J. Papasikos, D.MD., F.A.G.D, P.A.
• Jacy Papasikos, D.M.D
• Nicholas Papouchis, PH.D., ABPP
• Parabolic Performance & Rehab, LLC
• Susan C. Parente, PSY.D.
• Kang-Woo Daniel Park, DDS
• Carol B Parker, LCSW
• Mario Parker
• Jessica A Parks, OTR
• Lissa Parsonnet, PHD

• Interventional Pain Medicine Physician in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Interventional Pain Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.