Individual provider Active NPI

Chu Yong Jeong, O.D.

  • Optometrist
  • Aurora, CO
National Provider Identifier
1750554002
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2249 Issued in CO
Practice address
5001 S Parker Rd Ste 204
Aurora, CO 80015-1183
Phone
(720) 507-7004
Fax
(720) 570-7009
NPI assigned
Apr 8, 2008
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5481 OH
Optometrist 152W00000X 2249 CO Primary

Addresses

Primary practice location

5001 S Parker Rd Ste 204
Aurora, CO 80015-1183

Mailing address

5001 S. Parker Rd
Suite 204
Aurora, CO 80015
Phone (720) 507-7004

Other practice location 1

1500 Polaris Pkwy
Suite #1154
Columbus, OH 43240-2126
Phone (614) 846-9430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141114000703 CO Practitioner - Optometry 0840286787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5001 S Parker Rd
Suite 204
Aurora, CO 80015-1183
Phone (720) 870-0221

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5481OHMDClinical Psychologist
2249COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Envision Eye Care Optometrist CurrentSince Oct 1, 2015 Accepting new patients
Pearle Vision Inc Past Accepting new patients
Pearle Vision Inc Past Accepting new patients

Locations

5001 S Parker Rd
Ste 204
Aurora, CO 80015
Phone (720) 507-7004

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1750554002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 S. PARKER RD",
            "address_2": "SUITE 204",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "80015",
            "telephone_number": "720-507-7004",
            "fax_number": "720-507-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 S PARKER RD STE 204",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800151183",
            "telephone_number": "720-507-7004",
            "fax_number": "720-570-7009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Polaris Pkwy",
            "address_2": "Suite #1154",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432402126",
            "country_code": "US",
            "telephone_number": "614-846-9430",
            "fax_number": "614-846-9462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEONG",
        "first_name": "CHU",
        "middle_name": "YONG",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5481",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.