Individual provider Active NPI

Jonathan Lum Chin, MD

  • Urology Physician
  • Antioch, CA
National Provider Identifier
1841216892
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A77873 Issued in CA
Practice address
2350 Country Hills Dr Ste a
Antioch, CA 94509-7436
Phone
(925) 779-9097
Fax
(925) 779-0801
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X A77873 CA Primary

Addresses

Primary practice location

2350 Country Hills Dr Ste a
Antioch, CA 94509-7436

Mailing address

2350 Country Hills Dr Ste a
Antioch, CA 94509-7436
Phone (925) 779-9097

Other practice location 1

2637 Shadelands Dr
Walnut Creek, CA 94598-2512
Phone (925) 395-4022

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070203000076 CA Practitioner - Urology 2365444338 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Harvard Medical School, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bass Medical GroupGroup PAC ID 9032111281, 292 clinicians

Practice addresses (Care Compare)

1505 Saint Alphonsus Way
Alamo, CA 94507-1570
Phone (925) 932-6330

2350 Country Hills Dr
Antioch, CA 94509-7436

365 Lennon LN
Walnut Creek, CA 94598-5915

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.35 of 100Reported as individual
Quality
85.24
Promoting interoperability
100
Improvement activities
40
Cost
68.66

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection13
Removal of skin lesions114

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
John Muir Trauma Physicians Billing Service Current Accepting new patients
Bass Medical Group CurrentSince Jun 1, 2014 Accepting new patients
Bass Medical Group Current Accepting new patients
Bass Medical Group CurrentSince Jun 1, 2014 Accepting new patients
John Muir Trauma Physicians Billing Service Urology CurrentSince Sep 22, 2018 Accepting new patients
Sutter Delta Medical Center Past Accepting new patients
John Muir Health Past Accepting new patients
John Muir Health Past Accepting new patients
Pacific Urology a Medical Corporation Urology Past Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients
Bass Medical Group Past Accepting new patients
Bass Medical Group Past Accepting new patients

Locations

1505 Saint Alphonsus Way
Alamo, CA 94507
Phone (925) 837-4225

2350 Country Hills Dr
Ste A
Antioch, CA 94509
Phone (925) 464-1982

365 Lennon Ln
Ste 250
Walnut Creek, CA 94598
Phone (925) 627-3424

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

2637 Shadelands Dr
Walnut Creek, CA 94598
Phone (925) 627-3424

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jchin45700@ehr.johnmuirhealth.com

Organizations & group practices 12

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.

Hospital & facility affiliations 3

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1841216892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 COUNTRY HILLS DR STE A",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945097436",
            "telephone_number": "925-779-9097",
            "fax_number": "925-779-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 COUNTRY HILLS DR STE A",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945097436",
            "telephone_number": "925-779-9097",
            "fax_number": "925-779-0801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2637 Shadelands Dr",
            "address_purpose": "LOCATION",
            "city": "Walnut Creek",
            "state": "CA",
            "postal_code": "945982512",
            "country_code": "US",
            "telephone_number": "925-395-4022",
            "fax_number": "925-395-4425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHIN",
        "first_name": "JONATHAN",
        "middle_name": "LUM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A77873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

Verify at the official NPI Registry.