Individual provider Active NPI

Kyo Young Chu, M.D.

  • Anesthesiology Physician
  • Simi Valley, CA
National Provider Identifier
1982618088
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A50357 Issued in CA
Practice address
2975 Sycamore Dr
Simi Valley, CA 93065-1201
Phone
(805) 955-6900
Fax
(805) 955-6063
NPI assigned
Jul 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A50357 CA Primary

Addresses

Primary practice location

2975 Sycamore Dr
Simi Valley, CA 93065-1201

Mailing address

101 S 1St St
1000
Burbank, CA 91502-1938
Phone (818) 845-6206

Other identifiers 2

IdentifierTypeStateIssuer
00A503570MedicaidCA
00A503570OtherCABLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20110218000138 CA Practitioner - Anesthesiology 2860434602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Texas Medical School at Houston, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Simi Valley Anesthesia Medical GroupGroup PAC ID 2062454804, 26 clinicians

Practice addresses (Care Compare)

2975 Sycamore Dr
Simi Valley, CA 93065-1201
Phone (805) 955-6000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50357CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Simi Valley Anesthesia Medical Group Anesthesiology CurrentSince Apr 1, 2001 Accepting new patients
Simi Valley Hospital and Health Care Services Past Accepting new patients
Port City Operating Company, LLC Past Accepting new patients
Morpheus Anesthesia Inc Anesthesiology Past Accepting new patients
Delta Radiology, Inc. Past Accepting new patients

Locations

1920 E Los Angeles Ave
Simi Valley, CA 93065
Phone (805) 306-8800

2750 Sycamore Dr
Simi Valley, CA 93065
Phone (805) 955-6000

2975 Sycamore Dr
Simi Valley, CA 93065
Phone (805) 522-2500

550 Saint Charles Dr
Ste 101
Thousand Oaks, CA 91360
Phone (805) 557-7050

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982618088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S 1ST ST",
            "address_2": "1000",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915021938",
            "telephone_number": "818-845-6206",
            "fax_number": "818-845-9774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2975 SYCAMORE DR",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651201",
            "telephone_number": "805-955-6900",
            "fax_number": "805-955-6063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHU",
        "first_name": "KYO",
        "middle_name": "YOUNG",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A50357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A503570",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A503570",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

Verify at the official NPI Registry.