Mike Syru Chiang, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

018627 Issued in GA

Practice address

3294 North Oak Street Ext.
Valdosta, GA 31605

Phone

(229) 241-1188

Fax

(229) 245-7106

NPI assigned

Dec 8, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: mchiang@ucv.gwaydirect.com

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.

• Urological Clinic of Valdosta Ambulatory Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Valdosta, GA
  • NPI 1528404803
  NPD (past) Authorized official
• Hospital Authority of the City of Bainbridge and Decatur County

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)
• Hospital Authority of Valdosta and Lowndes County, Georgia

  • Ambulance
  • Valdosta, GA
  • NPI 1558141671
  NPD (past)

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331251200000",
    "number": "1720063100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3294 NORTH OAK STREET EXT",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "31605",
            "telephone_number": "229-241-1188",
            "fax_number": "229-245-7106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3294 NORTH OAK STREET EXT.",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "31605",
            "telephone_number": "229-241-1188",
            "fax_number": "229-245-7106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIANG",
        "first_name": "MIKE",
        "middle_name": "SYRU",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2012-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "018627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "340005901",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000244791B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayleigh M Chavarria, M.ED., CCC-SLP
• Marene Denise Chavis
• Hannah Cheek, FNP-C
• Catherine Ellen Cherof, OTR/L
• Sharon Chester
• Ven Chung Chiang, MD
• Mi Hyun Choi, FNP-C
• Choice Family Medicine, PC
• Choices for Life of Georgia, LLC
• Christa L Crawford LCSW PC

• Urology Physician in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Urology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.