Individual provider Active NPI

Keith Francis Chu Cheong, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Brooklyn, NY
National Provider Identifier
1902869985
Registry record updated Nov 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
247384 Issued in NY
Practice address
374 Stockholm St
C/O Faculty Practice
Brooklyn, NY 11237-4006
Phone
(718) 963-6551
Fax
(718) 963-6793
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 247384 NY Primary

Addresses

Primary practice location

374 Stockholm St
C/O Faculty Practice
Brooklyn, NY 11237-4006

Mailing address

374 Stockholm St
C/O Faculty Practice
Brooklyn, NY 11237-4006
Phone (718) 963-6551

Other identifiers 1

IdentifierTypeStateIssuer
02379037MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20130408000252 NY Practitioner - Pediatric MedicinePractitioner - PsychiatryPractitioner - Other (Physician) 7911142385 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
247384NYMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wyckoff Professional Medical Services, PC CurrentSince Mar 1, 2015 Accepting new patients
Samaritan Pediatric Services, P.C. CurrentSince Mar 1, 2018 Accepting new patients
Wyckoff Medical Services, P C Past Accepting new patients
Good Samaritan Hospital Medical Center Past Accepting new patients

Locations

655 Deer Park Ave
Babylon, NY 11702
Phone (631) 321-2100

374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: kchucheong39510@direct-chsli.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510012800000",
    "number": "1902869985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 STOCKHOLM ST",
            "address_2": "C/O FACULTY PRACTICE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374006",
            "telephone_number": "718-963-6551",
            "fax_number": "718-963-6793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 STOCKHOLM ST",
            "address_2": "C/O FACULTY PRACTICE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374006",
            "telephone_number": "718-963-6551",
            "fax_number": "718-963-6793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHU CHEONG",
        "first_name": "KEITH",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2017-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NY",
            "license": "247384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02379037",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.