Individual provider Active NPI

Ching Man Chung, O.D.

  • Optometrist
  • Staten Island, NY
National Provider Identifier
1508207531
Registry record updated Jul 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
007992 Issued in NY
Practice address
273 Eltingville Blvd
Staten Island, NY 10312-2447
Phone
(917) 554-1765
NPI assigned
Jul 6, 2013
Last updated
Jul 13, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 007992 NY Primary

Addresses

Primary practice location

273 Eltingville Blvd
Staten Island, NY 10312-2447

Mailing address

424 Cumberland St Apt 3
Brooklyn, NY 11238-1533
Phone (347) 387-7367

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140325000270 NY Practitioner - Optometry 4981835576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

565 Atlantic Ave
Brooklyn, NY 11217-1913
Phone (718) 622-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Victory Vision Care Inc. Optometrist CurrentSince Apr 8, 2017 Accepting new patients
Keith C Chang MD PLLC PastSince Nov 1, 2013 Accepting new patients
Victory Vision Center LLC Optometrist PastSince Apr 8, 2017 Accepting new patients
Alla Zlotina OD PC Optometrist PastSince Jul 24, 2013 Accepting new patients

Locations

565 Atlantic Ave
Brooklyn, NY 11217
Phone (718) 622-2020

Organizations & group practices 4

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": "1373068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373673600000",
    "number": "1508207531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 CUMBERLAND ST APT 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112381533",
            "telephone_number": "347-387-7367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "273 ELTINGVILLE BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103122447",
            "telephone_number": "917-554-1765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "CHING MAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-06",
        "last_updated": "2013-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "007992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.