David M Chacko, M.D., PH.D.

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

0429173 Issued in KS

Practice address

655 N Woodlawn
Wichita, KS 67208

Phone

(316) 684-5158

Fax

(316) 681-1005

NPI assigned

Dec 8, 2006

Last updated

Jan 29, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KS

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

Specialty

Ophthalmology

Education

Loma Linda University School of Medicine, 1987

Medicare assignment

May accept Medicare assignment

Group practices

Grene Vision Group LLCGroup PAC ID 1254324023, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wesley Medical Center Hospital, Wichita, KS, CCN 170123

Merit-based Incentive Payment System (MIPS)

Final score

90.42 of 100Reported as group

Quality

99.11

Improvement activities

40

Cost

69.26

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: david.chacko.p1@direct.gvg.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grene Vision Group LLC

  • Ophthalmology Physician
  • Wichita, KS
  • NPI 1285627562
  Medicare reassignment Care Compare group NPD
• Grene Vision Group LLC

  dba Grene Vision Group

  • Optometrist
  • Wichita, KS
  • NPI 1598215006

  Ophthalmology

  NPD
• Grene Vision Group LLC

  • Optometrist
  • Winfield, KS
  • NPI 1912119751

  Ophthalmology

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Wesley Medical Center LLC

  dba Wesley LifeWatch

  • Land Ambulance
  • Wichita, KS
  • NPI 1205760006

  Hospital

  Care Compare affiliation
• Wesley Medical Center LLC

  dba Wesley Medical Center

  • General Acute Care Hospital
  • Wichita, KS
  • NPI 1447299649
  Care Compare affiliation

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517184000000",
    "number": "1922167303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 N WEBB RD",
            "address_2": "ATTN FLR2",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063413",
            "telephone_number": "316-636-2010",
            "fax_number": "316-858-3830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 N WOODLAWN",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67208",
            "telephone_number": "316-684-5158",
            "fax_number": "316-681-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACKO",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2018-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KS",
            "license": "0429173",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "KS",
            "license": "0429173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100143410B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180043551",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cgcounseling
• CH Medical KS PA
• CH MH Services (KS), LLC
• Marc Robert Chace
• Breanna Nichole Chachere, MD
• Janna Voegele Chacko, MD
• Joyce Chadwick Eby, RN BSN
• Kristina Chaffee Khant, MD
• Caroline Marie Chaffin
• Aubony Rae Chalfant, LPC

• Retina Specialist (Ophthalmology) Physician in Wichita, KS
• Providers in Wichita, KS by specialty
• Retina Specialist (Ophthalmology) Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; 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.