Active NPI
Alexander Chong, MD, MPH
- Pediatrics Physician
- Maple Grove, MN
National Provider Identifier
1730875337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 82262
- Practice address
- 12720 Bass Lake Rd
Maple Grove, MN 55369-6307 - Phone
- (763) 559-2861
- NPI assigned
- Apr 17, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 82262 | MN | Primary |
Addresses
Primary practice location
12720 Bass Lake Rd
Maple Grove, MN 55369-6307
Mailing address
12720 Bass Lake Rd
Maple Grove, MN 55369-6307
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230718002968 | MN | Order and Referring Only - Pediatric Medicine | 4486014768 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784073600000",
"number": "1730875337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12720 BASS LAKE RD",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553696307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12720 BASS LAKE RD",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553696307",
"telephone_number": "763-559-2861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHONG",
"first_name": "ALEXANDER",
"name_prefix": "Dr.",
"credential": "MD, MPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-04-17",
"last_updated": "2026-07-15",
"certification_date": "2026-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "82262",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maple Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; 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.