NPIMap

Individual provider Active NPI

Andrew D Chung, M.D.

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1962500413
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K3134 Issued in TX
Practice address
3600 Gaston Ave
Suite 755
Dallas, TX 75246-1800
Phone
(214) 823-4200
Fax
(214) 823-4206
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X K3134 TX Primary

Addresses

Primary practice location

3600 Gaston Ave
Suite 755
Dallas, TX 75246-1800

Mailing address

3600 Gaston Ave
Suite 755
Dallas, TX 75246-1800
Phone (214) 823-4200

Other identifiers 5

IdentifierTypeStateIssuer
5572534OtherAETNA
031482502MedicaidTX
043042301MedicaidTX
110158386OtherRR MEDICARE
845115OtherBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090602000714 TX Practitioner - Internal Medicine 6507916145 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Tufts University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Andrew Chung, M.D. PLLCGroup PAC ID 6608991989, 5 clinicians

Practice addresses (Care Compare)

3600 Gaston Ave
Suite 755
Dallas, TX 75246-1907
Phone (214) 823-4200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K3134TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew Chung MD PLLC Internal Medicine CurrentSince May 13, 2010 Accepting new patients
Robert Ian Myers, MD, PA Internal Medicine Current Accepting new patients
DRS Carman Weston & Koster a Professional Association Internal Medicine Current Accepting new patients
Vesta Solutions Group, LLC PastSince May 21, 2014 Accepting new patients

Locations

3600 Gaston Ave
Ste 703
Dallas, TX 75246
Phone (214) 823-4200

3600 Gaston Ave
Ste 755
Dallas, TX 75246
Phone (214) 823-4200

4200 Live Oak St
Dallas, TX 75204
Phone (214) 821-0050

3600 Gaston Ave
Ste 1001
Dallas, TX 75246
Phone (214) 297-0200

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JDADBA
  • Direct secure messaging: andrew.chung@acmp.eclinicaldirectplus.com

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.

Hospital & facility affiliations 7

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415145600000",
    "number": "1962500413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE",
            "address_2": "SUITE 755",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461800",
            "telephone_number": "214-823-4200",
            "fax_number": "214-823-4206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE",
            "address_2": "SUITE 755",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461800",
            "telephone_number": "214-823-4200",
            "fax_number": "214-823-4206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "ANDREW",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2014-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K3134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5572534",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031482502",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043042301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110158386",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "845115",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.