Individual provider Active NPI

Susan J Chung, P.A.

  • Physician Assistant
  • Mineola, NY
National Provider Identifier
1821044967
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
007600-1 Issued in NY
Practice address
259 1St St
Mineola, NY 11501-3957
Phone
(516) 663-2727
Fax
(516) 663-8549
NPI assigned
May 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 007600-1 NY Primary

Addresses

Primary practice location

259 1St St
Mineola, NY 11501-3957

Mailing address

700 Hicksville Rd
Suite 204
Bethpage, NY 11714-3471
Phone (516) 576-5812

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address schung294971@nyumc.direct-ci.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050716000024 NY Practitioner - Physician Assistant 0446286892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
007600-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
Medical Group of Mineola, PC Past Accepting new patients

Locations

1300 Franklin Ave
Ste ML6
Garden City, NY 11530
Phone (516) 353-1900

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

120 Mineola Blvd
Ste 600
Mineola, NY 11501
Phone (516) 663-4525

259 1st St
Mineola, NY 11501
Phone (516) 576-1820

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1821044967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 HICKSVILLE RD",
            "address_2": "SUITE 204",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117143471",
            "telephone_number": "516-576-5812",
            "fax_number": "516-576-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 1ST ST",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013957",
            "telephone_number": "516-663-2727",
            "fax_number": "516-663-8549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "SUSAN",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "007600-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "schung294971@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "259 1st St",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115013957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.