Individual provider Active NPI

Jeff Chao, PA-C

  • Physician Assistant
  • Pleasantville, NY
National Provider Identifier
1619673449
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1172408 Issued in NY
Practice address
861 Bedford Rd
Pleasantville, NY 10570-2724
Phone
(866) 722-3338
NPI assigned
Feb 2, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1172408 NY Primary

Addresses

Primary practice location

861 Bedford Rd
Pleasantville, NY 10570-2724

Mailing address

2933 200TH St Apt 1F
Bayside, NY 11360-2306
Phone (626) 374-1754

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
I20230427002648 NY Practitioner - Physician Assistant 0941665822 Reassigns benefits to 1 organization
Practice locations: Bayside, NY

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10202 Liberty Ave
Ozone Park, NY 11417-1727
Phone (718) 571-9265

13657 Roosevelt Ave
Flushing, NY 11354-5509
Phone (929) 476-0463

16221 Jamaica Ave
Jamaica, NY 11432-4909
Phone (718) 571-9116

22405 Jamaica Ave
Queens Village, NY 11428-2019
Phone (718) 571-9395

2248 31St St
Astoria, NY 11105-2714
Phone (718) 571-9192

3111 Steinway St
Astoria, NY 11103-3908
Phone (718) 475-2345

3726 Junction Blvd
Corona, NY 11368-1741
Phone (718) 571-9310

5626 Myrtle Ave
Ridgewood, NY 11385-4736
Phone (718) 571-9714

6118 188TH St
Fresh Meadows, NY 11365-2713
Phone (718) 489-5003

7049 Austin St
Forest Hills, NY 11375-1033
Phone (718) 280-1245

7425 Grand Ave
Elmhurst, NY 11373-4126
Phone (718) 803-2273

9107 Jamaica Ave
Woodhaven, NY 11421-2106
Phone (929) 476-0443

9119 Queens Blvd
Elmhurst, NY 11373-5531
Phone (646) 647-1253

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
029697NYMDMassage Therapist
1172408NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince Jun 10, 2023 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Jun 10, 2023 Accepting new patients

Locations

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

Interoperability endpoints

  • Direct secure messaging: jeff.chao.1@2983.direct.athenahealth.com

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": "1675296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1619673449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2933 200TH ST APT 1F",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602306",
            "telephone_number": "626-374-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "861 BEDFORD RD",
            "city": "PLEASANTVILLE",
            "state": "NY",
            "postal_code": "105702724",
            "telephone_number": "866-722-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAO",
        "first_name": "JEFF",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-02",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "1172408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasantville, NY

Sources for this page

Verify at the official NPI Registry.