Individual provider Active NPI

Michael Tzyy-Shyan Chuang, DO

  • Sports Medicine (Family Medicine) Physician
  • San Marcos, CA
National Provider Identifier
1487098802
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
20A13562 Issued in CA
Practice address
400 Craven Rd
San Marcos, CA 92078-4201
Phone
(866) 459-2912
NPI assigned
Apr 29, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 20A13562 CA Primary

Addresses

Primary practice location

400 Craven Rd
San Marcos, CA 92078-4201

Mailing address

400 Craven Rd
San Marcos, CA 92078-4201
Phone (866) 459-2912

Other names 1

  • Michael Tzyy Shyan Chuang Other name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171004002062 CA Practitioner - Family PracticePractitioner - Sports Medicine 6709025190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

400 Craven Rd
San Marcos, CA 92078-4201
Phone (619) 528-5000

4647 Zion Ave
San Diego, CA 92120-2507
Phone (619) 528-5000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13562CAMDAcupuncturist
20A13562CAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 28, 2017 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 28, 2017 Accepting new patients

Locations

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

400 Craven Rd
San Marcos, CA 92078
Phone (760) 510-5336

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1487098802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CRAVEN RD",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920784201",
            "telephone_number": "866-459-2912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CRAVEN RD",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920784201",
            "telephone_number": "866-459-2912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUANG",
        "first_name": "MICHAEL",
        "middle_name": "TZYY-SHYAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-29",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "20A13562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "CHUANG",
            "middle_name": "TZYY SHYAN",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Marcos, CA

Sources for this page

Verify at the official NPI Registry.