Eileen Chong, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110008019 Issued in VA

Practice address

11701 Livingston Rd Ste 302
Ft Washington, MD 20744-5146

Phone

(012) 926-0103

Fax

(301) 203-1838

NPI assigned

Jul 27, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, VA, MD3 enrollments

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 3

Specialty

Physician Assistant

Education

George Washington University School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Dermatology of Maryland PCGroup PAC ID 9931489804, 43 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Advanced Dermatology of Maryland PC

  • Dermatology Physician
  • Rockville, MD
  • NPI 1760856413

  DC, Single Specialty

  Medicare reassignment Care Compare group NPD (past)
• Skin and Laser Surgery Center

  • MOHS-Micrographic Surgery Physician
  • Vienna, VA
  • NPI 1720277932
  Medicare reassignment
• Advanced Dermatology of Maryland PC

  • Dermatology Physician
  • Fort Washington, MD
  • NPI 1386479004
  NPD
• Advanced Dermatology of Maryland PC

  • Dermatology Physician
  • La Plata, MD
  • NPI 1477388197

  Single Specialty

  NPD

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

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1851064752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13704 CHIANTI CT",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201513274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11701 LIVINGSTON RD STE 302",
            "city": "FT WASHINGTON",
            "state": "MD",
            "postal_code": "207445146",
            "telephone_number": "012-926-0103",
            "fax_number": "301-203-1838"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Centennial St Ste H",
            "address_purpose": "LOCATION",
            "city": "LA Plata",
            "state": "MD",
            "postal_code": "206465976",
            "country_code": "US",
            "telephone_number": "301-292-6010",
            "fax_number": "240-344-2815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHONG",
        "first_name": "EILEEN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-27",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110008019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• John D Clark, MSW, LCSW-C
• Dascha Cleckley
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• Fatima Cochran, LCPC
• Kristin Cokley

• Physician Assistant in Ft Washington, MD
• Providers in Ft Washington, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; 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.