Individual provider Active NPI

Young Jun Chai

  • Emergency Medicine Physician
  • Lawrenceville, GA
National Provider Identifier
1841684446
Registry record updated Jul 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
79584 Issued in GA
Practice address
173 August West Way
Lawrenceville, GA 30046
Phone
(201) 566-8064
NPI assigned
Mar 23, 2015
Last updated
Jul 18, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 79584 GA Primary

Addresses

Primary practice location

173 August West Way
Lawrenceville, GA 30046

Mailing address

173 August West Way
Lawrenceville, GA 30046-9465
Phone (201) 566-8064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20180822003496 GA Practitioner - Emergency Medicine 7911226980 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rutgers New Jersey Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians

Practice addresses (Care Compare)

2151 W Spring St
Monroe, GA 30655-3202
Phone (770) 267-8461

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79584GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Emergency Associates, LLC Emergency Medicine CurrentSince Mar 23, 2020 Accepting new patients
Gwinnett Emergency Specialists Observation Services, LLC Emergency Medicine CurrentSince Aug 6, 2019 Accepting new patients
Inphynet Primary Care Physicians Southeast PC Emergency Medicine CurrentSince Aug 1, 2018 Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Jul 10, 2018 Accepting new patients

Locations

2122 Manchstr Expy
Columbus, GA 31904
Phone (706) 320-3128

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

Organizations & group practices 4

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 1

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": "1427068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1841684446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 AUGUST WEST WAY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300469465",
            "telephone_number": "201-566-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 AUGUST WEST WAY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30046",
            "telephone_number": "201-566-8064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAI",
        "first_name": "YOUNG",
        "middle_name": "JUN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-23",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "79584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.