Willis Clement Chung, M.D.

Primary specialty

Neuroradiology PhysicianTaxonomy code 2085N0700X

License

64006 Issued in MN

Practice address

7595 Anagram Dr
Eden Prairie, MN 55344-7399

Phone

(612) 573-2200

Fax

(612) 573-2274

NPI assigned

Dec 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TX, FL, OH, ND, PA, WA6 enrollments

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 6

Specialty

Diagnostic Radiology

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Columbus Radiology CorpGroup PAC ID 6507754983, 290 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• MH St Elizabeth Youngstown Hospital Hospital, Youngstown, OH, CCN 360064
• HMHP St Elizabeth Boardman Health Center Hospital, Boardman, OH, CCN 360276
• MH St Joseph Warren Hospital Hospital, Warren, OH, CCN 360161
• Mercy Regional Medical Center Hospital, Lorain, OH, CCN 360172
• Southeastern Ohio Regional Medical Center Hospital, Cambridge, OH, CCN 360203

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 34)

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.

• Columbus Radiology Corp

  • Diagnostic Radiology Physician
  • Columbus, OH
  • NPI 1669408159

  FL, PA, TX, WA

  Medicare reassignment Care Compare group NPD
• Aultman Now Urgent Care, LLC

  • Urgent Care Clinic/Center
  • North Canton, OH
  • NPI 1225662927
  Medicare reassignment NPD
• Mercy Medical Center

  • Psychiatry Physician
  • Williston, ND
  • NPI 1801928593
  Medicare reassignment NPD
• Mercy Medical Center

  • Critical Access Hospital
  • Williston, ND
  • NPI 1902824576
  Medicare reassignment NPD
• Radiology Associates of Canton, Inc.

  • Diagnostic Radiology Physician
  • Canton, OH
  • NPI 1912982034

  Neuroradiology, TX

  Medicare reassignment NPD
• Mercy Home Care

  • Home Health Agency
  • Williston, ND
  • NPI 1871593723
  NPD
• Mercy Medical Center

  • Diagnostic Radiology Physician
  • Williston, ND
  • NPI 1629234257
  NPD
• Diagnostic Imaging Associates

  • Diagnostic Radiology Physician
  • Englewood, CO
  • NPI 1447299425
  NPD (past)
• Greeley Xray Group PC

  • Specialist
  • Greeley, CO
  • NPI 1053341008
  NPD (past)
• Quest Diagnostics LLC Il

  • Clinical Medical Laboratory
  • Chicago, IL
  • NPI 1669298055
  NPD (past)
• Radiology Imaging of Nebraska, LLC

  • Diagnostic Radiology Physician
  • Scottsbluff, NE
  • NPI 1184869901
  NPD (past)

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

• Mercy Health Youngstown LLC

  • Clinical Medical Laboratory
  • Warren, OH
  • NPI 1538233309

  Hospital

  Care Compare affiliation
• Mercy Health Youngstown LLC

  • General Acute Care Hospital
  • Youngstown, OH
  • NPI 1548296106
  Care Compare affiliation
• Mercy Health Youngstown LLC

  • General Acute Care Hospital
  • Warren, OH
  • NPI 1629009964
  Care Compare affiliation
• Mercy Health Youngstown LLC

  • General Acute Care Hospital
  • Youngstown, OH
  • NPI 1790868982
  Care Compare affiliation
• Mercy Health Youngstown LLC

  • Clinical Medical Laboratory
  • Youngstown, OH
  • NPI 1831600295

  Hospital

  Care Compare affiliation
• Mercy Health-Regional Medical Center LLC

  • Clinical Medical Laboratory
  • Lorain, OH
  • NPI 1164971800

  Hospital

  Care Compare affiliation
• Mercy Health-Regional Medical Center LLC

  • General Acute Care Hospital
  • Lorain, OH
  • NPI 1245274950
  Care Compare affiliation
• Southeastern Ohio Regional Medical Center Inc

  • Rural Acute Care Hospital
  • Cambridge, OH
  • NPI 1346247350
  Care Compare affiliation

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1659357804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7595 ANAGRAM DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447399",
            "telephone_number": "612-573-2200",
            "fax_number": "612-573-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7595 ANAGRAM DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447399",
            "telephone_number": "612-573-2200",
            "fax_number": "612-573-2274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 W Gore Blvd",
            "address_purpose": "LOCATION",
            "city": "Lawton",
            "state": "OK",
            "postal_code": "735056332",
            "country_code": "US",
            "telephone_number": "580-355-8699 x3217",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5025 Hummingbird Ln",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750937527",
            "country_code": "US",
            "telephone_number": "970-381-7888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "WILLIS",
        "middle_name": "CLEMENT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "P3700",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "33420",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MN",
            "license": "64006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01334200",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCRE MIC",
            "identifier": "P00002241",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCRE RIA",
            "identifier": "P00031103",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WY MEDICAID",
            "identifier": "1659357804",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peerapod Chiowanich, MD
• Nicholas Chirico Jr.
• Parina Gupta Cho, MD
• Choice Transport Services Inc
• Diana Marie Christensen
• Thomas J. Church, M.D.
• Virginia Irene Church, HIS
• Amy Churchill, PT
• Rachel Joy Churchill, PHD
• Karen Kay Cierzan, MA, LPCC

• Neuroradiology Physician in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Neuroradiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.