Susie Chung MD PC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

211617 Issued in NY

Legal business name

SUSIE CHUNG MD PC

Practice address

139 Centre St. Suite 320
New York, NY 10013-3100

Phone

(212) 334-1207

NPI assigned

May 24, 2007

Organization subpart

No

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

Authorized official

Name

Susie Chung, M.D.NPI 1760417471

Title

President

Phone

(347) 392-7474

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susie Chung, M.D.

  • Nephrology Physician
  • New York, NY
  • NPI 1760417471
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350604800000",
    "number": "1942411798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1418",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101561418",
            "telephone_number": "347-392-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 CENTRE ST. SUITE 320",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100133100",
            "telephone_number": "212-334-1207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSIE CHUNG MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2012-10-19",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "SUSIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-392-7474",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "211617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nephrology Physician in New York, NY
• Providers in New York, NY by specialty
• Nephrology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.