Individual provider Active NPI

Charito Chua Go, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Omaha, NE
National Provider Identifier
1871534198
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
21065 Issued in OK
Practice address
981225 Nebraska Medical Ctr
Omaha, NE 68198-5075
Phone
(402) 836-9288
Fax
(402) 559-8940
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 21065 OK Primary
Physical Medicine & Rehabilitation Physician 208100000X K5960 TX

Addresses

Primary practice location

981225 Nebraska Medical Ctr
Omaha, NE 68198-5075

Mailing address

981225 Nebraska Medical Ctr
Omaha, NE 68198-1225
Phone (402) 836-9288

Other practice location 1

300 Rockefeller Dr
Muskogee, OK 74401-5075
Phone (918) 684-3374

Other practice location 2

3131 Troup Hwy
Tyler, TX 75701-8350
Phone (903) 510-7006

Other identifiers 7

IdentifierTypeStateIssuer
TXB102731OtherTXGROUP PTAN
0464885-07OtherTXIND TPI
200823140AMedicaidOK
2035487-02OtherTXGROUP TPI
317142YMNOOtherTXMEDICARE PTAN
8DW142OtherTXBCBS
046488505MedicaidTX

Other names 1

  • Charito Chua Go-Von Hendy Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040708000182 TX Practitioner - Physical Medicine and Rehabilitation 1850379827 Reassigns benefits to 1 organization
I20210520000294 NE Practitioner - Physical Medicine and RehabilitationPractitioner - Medical Oncology 1850379827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

800 E Dawson St
Christus Trinity Clinic
Tyler, TX 75701-2036
Phone (903) 510-1186

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21065OKMDPhysical Medicine & Rehabilitation Physician
K5960TXMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unmc Physicians CurrentSince Jul 1, 2021 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jul 3, 2023 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jul 3, 2023 Accepting new patients
Nelson V Valena MD PA Past Accepting new patients
Tyler Rehab Associates, L.P. Past Accepting new patients

Locations

Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731

988102 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-5600

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

3131 Troup Hwy
Tyler, TX 75701
Phone (903) 510-7000

Organizations & group practices 5

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1871534198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981225 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681981225",
            "telephone_number": "402-836-9288",
            "fax_number": "402-559-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "981225 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681985075",
            "telephone_number": "402-836-9288",
            "fax_number": "402-559-8940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Rockefeller Dr",
            "address_purpose": "LOCATION",
            "city": "Muskogee",
            "state": "OK",
            "postal_code": "744015075",
            "country_code": "US",
            "telephone_number": "918-684-3374",
            "fax_number": "918-681-6814",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3131 Troup Hwy",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757018350",
            "country_code": "US",
            "telephone_number": "903-510-7006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GO",
        "first_name": "CHARITO",
        "middle_name": "CHUA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OK",
            "license": "21065",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "K5960",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "TXB102731",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND TPI",
            "identifier": "0464885-07",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200823140A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP TPI",
            "identifier": "2035487-02",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "317142YMNO",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8DW142",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046488505",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARITO",
            "last_name": "GO-VON HENDY",
            "middle_name": "CHUA",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.