Individual provider Active NPI

Ferdinand Philip Chua, MD

  • Internal Medicine Physician
  • Washington, DC
National Provider Identifier
1861474975
Registry record updated Feb 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD037395 Issued in DC
Practice address
1160 Varnum St NE
Suite 008
Washington, DC 20017-2107
Phone
(202) 526-3897
Fax
(202) 526-7723
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD037395 DC Primary

Addresses

Primary practice location

1160 Varnum St NE
Suite 008
Washington, DC 20017-2107

Mailing address

1160 Varnum St NE
Suite 008
Washington, DC 20017-2107
Phone (202) 526-3897

Other identifiers 2

IdentifierTypeStateIssuer
1861474975MedicaidVA
0403196 00MedicaidDC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20090127000675 DC Practitioner - Internal Medicine 2264596816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mamonluk Chua Medical Group, PCGroup PAC ID 0749344398, 2 clinicians

Practice addresses (Care Compare)

1160 Varnum St NE
Suite 8
Washington, DC 20017-2110
Phone (202) 526-3879

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.9 of 100Reported as group
Quality
93.71
Improvement activities
40
Cost
81.4

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD037395DCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mamonluk Chua Medical Group, PC Internal Medicine CurrentSince Jan 1, 2009 Accepting new patients
Carroll Manor Past Accepting new patients
Green Valley Rural Clinics, LLC Past Accepting new patients

Locations

1160 Varnum St NE
Ste 8
Washington, DC 20017
Phone (202) 526-3897

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EEJFAA

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.

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234656000000",
    "number": "1861474975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 VARNUM ST NE",
            "address_2": "SUITE 008",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172107",
            "telephone_number": "202-526-3897",
            "fax_number": "202-526-7723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 VARNUM ST NE",
            "address_2": "SUITE 008",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172107",
            "telephone_number": "202-526-3897",
            "fax_number": "202-526-7723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUA",
        "first_name": "FERDINAND",
        "middle_name": "PHILIP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2009-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD037395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861474975",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0403196 00",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.