Individual provider Active NPI

Susie Chun, M.D.

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1912144981
Registry record updated Jun 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A106402 Issued in CA
Practice address
550 1St Ave
New York, NY 10016-6402
Phone
(646) 501-4139
NPI assigned
Jan 13, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A106402 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 273646 NY
Emergency Medicine Physician 207P00000X 273646 NY

Addresses

Primary practice location

550 1St Ave
New York, NY 10016-6402

Mailing address

550 1St Ave
New York, NY 10016-6402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, WA2 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
I20190807003137 HI Practitioner - Emergency Medicine 9830241108 Reassigns benefits to 1 organization
I20240628003372 WA Practitioner - Emergency Medicine 9830241108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of California, San Francisco School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12607 SE Mill Plain Blvd
Vancouver, WA 98684-4098
Phone (800) 813-2000

Merit-based Incentive Payment System (MIPS)

Final score
83.72 of 100Reported as group
Quality
67.55
Promoting interoperability
100
Improvement activities
40
Cost
78.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
106402CAMDPeriodontist
7091AKMDLicensed Practical Nurse
A106402CAMDEmergency Medicine Physician
273646NYMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Emergency Medicine Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jun 17, 2024 Accepting new patients
Manor Care of Salmon Creek Wa, Association CurrentSince Jun 17, 2024 Accepting new patients
Straub Clinic & Hospital CurrentSince Jun 17, 2019 Accepting new patients
Straub Clinic & Hospital CurrentSince Jun 17, 2019 Accepting new patients
Golden State Emergency Physicians Inc Emergency Medicine Past Accepting new patients
Chase Dennis Emergency Medical Group Inc Emergency Medicine Past Accepting new patients
Denali Emergency Medicine Assoc PC Emergency Medicine PastSince Jan 29, 2023 Accepting new patients

Locations

888 S King St
Honolulu, HI 96813
Phone (808) 522-4000

500 NE Multnomah St
Fl 11
Portland, OR 97232

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

12607 SE Mill Plain Blvd
Vancouver, WA 98684
Phone (360) 418-6001

Organizations & group practices 8

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": "1231804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498176000000",
    "number": "1912144981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "646-501-4139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUN",
        "first_name": "SUSIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-13",
        "last_updated": "2017-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A106402",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NY",
            "license": "273646",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "273646",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.