Jay Chung, MD

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

12393 Issued in NV

Practice address

155 Hwy 50
Stateline, NV 89449

Phone

(775) 589-8900

Fax

(775) 588-7110

NPI assigned

Sep 14, 2006

Last updated

Jul 16, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

RheumatologyAlso: Internal Medicine

Education

University of Texas Medical School at Houston, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jchung66292@direct.renown.org

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD (past)
• Tahoe Carson Valley Medical Group Inc

  • Family Medicine Physician
  • South Lake Tahoe, CA
  • NPI 1508865528
  Medicare reassignment
• Providence Medical Foundation

  • Obstetrics & Gynecology Physician
  • Napa, CA
  • NPI 1205131950
  NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• Mt Grant General Hospital

  • Critical Access Hospital
  • Hawthorne, NV
  • NPI 1801844527
  NPD (past)
• Prime Healthcare Services - Reno LLC

  dba Saint Mary's Regional Medical Center

  • General Acute Care Hospital
  • Reno, NV
  • NPI 1801152566
  NPD (past)
• South Lyon Health Center, Inc.

  dba South Lyon Medical Center

  • Physical Therapist
  • Yerington, NV
  • NPI 1407815194
  NPD (past)
• Sparks Family Hospital Inc

  dba Northern Nevada Medical Center

  • General Acute Care Hospital
  • Sparks, NV
  • NPI 1548250582
  NPD (past)
• Tahoe Carson Valley Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Stateline, NV
  • NPI 1124334776
  NPD (past)
• Barton Medical Foundation

  • Family Medicine Physician
  • South Lake Tahoe, CA
  • NPI 1750950499
  NPD (past)
• St. Joseph Health Northern California, LLC

  dba Providence St. Joseph Hospital

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1609858950
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1760588305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 EMERALD BAY RD",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961506207",
            "telephone_number": "530-543-5659",
            "fax_number": "530-541-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 HWY 50",
            "city": "STATELINE",
            "state": "NV",
            "postal_code": "89449",
            "telephone_number": "775-589-8900",
            "fax_number": "775-588-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "A67374",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NV",
            "license": "12393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barton Healthcare System
• Dennis Doyle Bowman, D.D.S
• Benjamin Daniel Bradford, M.D.
• Steven Laurence Brooks, MD
• Patricia Anne Bucher, NP
• Cosmetic Dermatology by Sean Degnan
• Sean M Degnan, M.D.
• Nichole Delaplante, DO
• Tania Josephine Dickson-Humphries, PA-C
• Eric J Ewald Jr., MD

• Rheumatology Physician in Stateline, NV
• Providers in Stateline, NV by specialty
• Rheumatology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.