Active NPI
Chin Thapvongse, MD
- Pediatrics Physician
- Bronx, NY
National Provider Identifier
1972679611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 133396
- Practice address
- 1269 Grand Concourse
Bronx, NY 10452 - Phone
- (718) 293-3424
- Fax
- (718) 293-3424
- NPI assigned
- Nov 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 133396 | NY | Primary |
Addresses
Primary practice location
1269 Grand Concourse
Bronx, NY 10452
Mailing address
28 Birchdale Lane
Port Washington, NY 10050-4502
Phone (516) 627-2505
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00439978 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 133396 | NY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972679611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 BIRCHDALE LANE",
"city": "PORT WASHINGTON",
"state": "NY",
"postal_code": "100504502",
"telephone_number": "516-627-2505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1269 GRAND CONCOURSE",
"city": "BRONX",
"state": "NY",
"postal_code": "10452",
"telephone_number": "718-293-3424",
"fax_number": "718-293-3424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THAPVONGSE",
"first_name": "CHIN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "133396",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00439978",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.