Individual provider Active NPI

Alan Kho Chua

  • Family Nurse Practitioner
  • Wilmington, MA
National Provider Identifier
1700588266
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2350944 Issued in MA
Practice address
222 Main St
Wilmington, MA 01887-2341
Phone
(978) 658-3377
NPI assigned
Mar 20, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X MCS008965B MA
Family Nurse Practitioner 363LF0000X RN2350944 MA Primary

Addresses

Primary practice location

222 Main St
Wilmington, MA 01887-2341

Mailing address

222 Main St
Wilmington, MA 01887-2341

Other practice location 1

300 Canal St
Salem, MA 01970-4558
Phone (866) 389-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20230517001856 MA Practitioner - Nurse Practitioner 8325404312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lynn Community Health, Inc.Group PAC ID 0042217507, shared by 2 NPIs, 95 clinicians
Hallmark Health Medical Associates IncGroup PAC ID 4385638782, 151 clinicians

Practice addresses (Care Compare)

20 Central Ave
Lynn, MA 01901-1314

269 Union St
Lynn, MA 01901-1314
Phone (959) 216-7305

578 Main St
Malden, MA 02148-3900
Phone (781) 321-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MCS008965BMAMDFamily Nurse Practitioner
RN2350944MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Edward M. Kennedy Community Health Center, Inc CurrentSince Apr 23, 2024 Accepting new patients
Edward M. Kennedy Community Health Center, Inc CurrentSince Apr 23, 2024 Accepting new patients

Locations

354 Waverley St
Framingham, MA 01702
Phone (508) 270-5700

650 Lincoln St
Worcester, MA 01605
Phone (508) 532-7318

19 Tacoma St
Worcester, MA 01605
Phone (508) 854-2122

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": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1700588266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 MAIN ST",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018872341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 MAIN ST",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018872341",
            "telephone_number": "978-658-3377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Canal St",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "MA",
            "postal_code": "019704558",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUA",
        "first_name": "ALAN",
        "middle_name": "KHO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-20",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "MCS008965B",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2350944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, MA

Sources for this page

Verify at the official NPI Registry.