Individual provider Active NPI

Bun Khirt Cheng, PA

  • Surgical Physician Assistant
  • New York, NY
National Provider Identifier
1558575316
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0058391 Issued in NY
Practice address
10 Union SQ E
Phillips Ambulatory Care Center Suite 3M
New York, NY 10003-3314
Phone
(212) 420-2494
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0058391 NY Primary

Addresses

Primary practice location

10 Union SQ E
Phillips Ambulatory Care Center Suite 3M
New York, NY 10003-3314

Mailing address

455 2ND Ave Apt 2a
New York, NY 10010-2404
Phone (347) 268-3287

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191212001173 NY Practitioner - Physician Assistant 8426481086 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0058391NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Oct 15, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Oct 15, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

17 E 102nd St
New York, NY 10029
Phone (212) 241-7968

10 Union Sq E
Ste 3M
New York, NY 10003
Phone (212) 288-2200

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

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": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558575316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 2ND AVE APT 2A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100102404",
            "telephone_number": "347-268-3287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 UNION SQ E",
            "address_2": "PHILLIPS AMBULATORY CARE CENTER SUITE 3M",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033314",
            "telephone_number": "212-420-2494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENG",
        "first_name": "BUN KHIRT",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "0058391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.