Individual provider Active NPI

Lawrence Chua, M.D.

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1487613691
Registry record updated Sep 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
31669 Issued in AZ
Practice address
19829 N 27TH Ave
Phoenix, AZ 85027-4001
Phone
(602) 505-4479
Fax
(602) 879-1876
NPI assigned
Mar 17, 2006
Last updated
Sep 16, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 31669 AZ Primary
Hospitalist Physician 208M00000X 31669 AZ

Addresses

Primary practice location

19829 N 27TH Ave
Phoenix, AZ 85027-4001

Mailing address

3655 W Anthem Way
Suite a-109; PMB 313
Anthem, AZ 85086-0430
Phone (602) 505-4479

Other identifiers 1

IdentifierTypeStateIssuer
796443MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20031118001046 AZ Practitioner - Internal Medicine 3375457708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ternion Physician Group, PLLCGroup PAC ID 6709157589, 5 clinicians

Practice addresses (Care Compare)

4704 W Diana Ave
Glendale, AZ 85302-5125
Phone (623) 505-9880

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31669AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ternion Physician Group, PLLC Internal Medicine CurrentSince Jan 18, 2023 Accepting new patients
Glendale Healthcare Associates LLC Past Accepting new patients

Locations

3655 W Anthem Way
Ste A109
Anthem, AZ 85086
Phone (623) 505-4479

4704 W Diana Ave
Glendale, AZ 85302
Phone (623) 247-3949

42104 N Venture Dr
Ste D118
Phoenix, AZ 85086
Phone (623) 505-4479

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284595200000",
    "number": "1487613691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3655 W ANTHEM WAY",
            "address_2": "SUITE A-109; PMB 313",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "850860430",
            "telephone_number": "602-505-4479",
            "fax_number": "602-879-1876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19829 N 27TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274001",
            "telephone_number": "602-505-4479",
            "fax_number": "602-879-1876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUA",
        "first_name": "LAWRENCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2010-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "31669",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "31669",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "796443",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.