NPIMap

Individual provider Active NPI

Kelli Hyun-Chung Chung, M.D.

  • Surgery Physician
  • Silverdale, WA
National Provider Identifier
1760584288
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD00045206 Issued in WA
Practice address
2200 NW Myhre Rd
Silverdale, WA 98383-7681
Phone
(360) 830-1250
Fax
(360) 830-1289
NPI assigned
Sep 4, 2006
Last updated
Feb 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD00045206 WA Primary
Surgery Physician 208600000X MD24641 OR

Addresses

Primary practice location

2200 NW Myhre Rd
Silverdale, WA 98383-7681

Mailing address

9621 Ridgetop Blvd NW
Silverdale, WA 98383-8502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050829001095 WA Practitioner - General Surgery 0941277792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Rochester School of Medicine and Dentistry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

2200 NW Myhre Rd
Silverdale, WA 98383-7681
Phone (360) 830-1100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy24
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group Surgery CurrentSince Sep 3, 2016 Accepting new patients
Franciscan Medical Group CurrentSince Sep 3, 2016 Accepting new patients
McKenzie Surgical Group PC Surgery Past Accepting new patients
McKenzie Physician Services LLC Past Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

450 S Kitsap Blvd
Ste 250
Port Orchard, WA 98366
Phone (360) 782-3000

19245 7th Ave NE
#O
Poulsbo, WA 98370
Phone (360) 782-3500

2200 NW Myhre Rd
Silverdale, WA 98383
Phone (360) 830-1100

9398 Ridgetop Blvd NW
#O
Silverdale, WA 98383
Phone (360) 782-3200

9621 Ridgetop Blvd NW
Silverdale, WA 98383
Phone (360) 782-3300

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: kelli.chung@tdc.directbygreenway.com

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1157328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1760584288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9621 RIDGETOP BLVD NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 NW MYHRE RD",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983837681",
            "telephone_number": "360-830-1250",
            "fax_number": "360-830-1289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "KELLI",
        "middle_name": "HYUN-CHUNG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-04",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD00045206",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD24641",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

Verify at the official NPI Registry.