Individual provider Active NPI

Kyung H Chu

  • Adult Health Nurse Practitioner
  • Belleville, NJ
National Provider Identifier
1962724393
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F305303-1 Issued in NY
Practice address
1 Clara Maass Dr Ste 200
Belleville, NJ 07109-3550
Phone
(973) 751-8880
Fax
(973) 751-8950
NPI assigned
Feb 26, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F305303-1 NY Primary

Addresses

Primary practice location

1 Clara Maass Dr Ste 200
Belleville, NJ 07109-3550

Mailing address

1 Clara Maass Dr Ste 200
Belleville, NJ 07109-3550
Phone (973) 751-8880

Other identifiers 1

IdentifierTypeStateIssuer
26NJ00737300OtherNJMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251011000418 NJ Practitioner - Nurse Practitioner 3779873047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Cancer Care Associates LLCGroup PAC ID 5294710091, 148 clinicians

Practice addresses (Care Compare)

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (844) 346-7222

776 E 3Rd Ave
Roselle, NJ 07203-1698
Phone (609) 835-2900

Hospital & facility affiliations

  • Clara Maass Medical Center Hospital, Belleville, NJ, CCN 310009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F305303-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Cancer Care Associates LLC CurrentSince Sep 1, 2025 Accepting new patients
Regional Cancer Care Associates LLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

1 Clara Maass Dr
Belleville, NJ 07109
Phone (973) 450-2008

1 Clara Maass Dr
Ste 200
Belleville, NJ 07109
Phone (973) 744-8000

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

1 Bay Ave
Montclair, NJ 07042
Phone (973) 429-6100

1 Bay Ave
Ste 2
Montclair, NJ 07042
Phone (201) 792-9011

776 E 3rd Ave
Roselle, NJ 07203
Phone (908) 241-5545

Interoperability endpoints

  • Direct secure messaging: kchu250990@epicdirect.rwjbh.org

Organizations & group practices 2

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 1

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": "1267142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1962724393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CLARA MAASS DR STE 200",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071093550",
            "telephone_number": "973-751-8880",
            "fax_number": "973-751-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CLARA MAASS DR STE 200",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071093550",
            "telephone_number": "973-751-8880",
            "fax_number": "973-751-8950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHU",
        "first_name": "KYUNG",
        "middle_name": "H",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-26",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F305303-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "26NJ00737300",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, NJ

Sources for this page

Verify at the official NPI Registry.