Individual provider Active NPI

Jae Woo Chung, DPM

  • Foot & Ankle Surgery Podiatrist
  • North Babylon, NY
National Provider Identifier
1528448487
Registry record updated Jul 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
N0069351 Issued in NY
Practice address
1231 Deer Park Ave
North Babylon, NY 11703
Phone
(631) 667-0388
NPI assigned
Jun 5, 2015
Last updated
Jul 31, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Foot & Ankle Surgery Podiatrist 213ES0103X N0069351 NY Primary

Addresses

Primary practice location

1231 Deer Park Ave
North Babylon, NY 11703

Mailing address

1231 Deer Park Ave
North Babylon, NY 11703-3104
Phone (631) 667-0388

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
I20180718001179 NY Practitioner - Podiatry 1850648171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Long Island Comprehensive Medical Care PLLCGroup PAC ID 3678731908, 41 clinicians

Practice addresses (Care Compare)

1231 Deer Park Ave
North Babylon, NY 11703-3104
Phone 6316670388612

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.32 of 100Reported as group
Quality
73.65
Promoting interoperability
95
Improvement activities
40
Cost
71.58

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue31
Removal of skin lesions1-10
Removal of nail tissue726
Removal or shaving of skin growth35
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N0069351NYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Shahzad Iqbal Physician PLLC Multi-Specialty PastSince Aug 1, 2018 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jaewoo.chung@lcmc.eclinicaldirectplus.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1433462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1528448487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 DEER PARK AVE",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117033104",
            "telephone_number": "631-667-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 DEER PARK AVE",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "11703",
            "telephone_number": "631-667-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "JAE WOO",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-05",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N0069351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Babylon, NY

Sources for this page

Verify at the official NPI Registry.