Peter Dongil Chung, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

58763 Issued in CA

Practice address

6311 Mary Theresa CT
Hanover, MD 21076-1028

Phone

(302) 430-1974

NPI assigned

Aug 19, 2008

Last updated

Dec 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, CA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Northwest Hospital Center, Inc

  dba NW Breast Care Ctr,Hospitalist,PA, SHS Plastics,Surgical House Staff

  • Hospitalist Physician
  • Randallstown, MD
  • NPI 1508961988

  Physician Assistant

  Medicare reassignment NPD
• Minghsun Liu, M.D., PC

  dba Woundtech of California

  • Infectious Disease Physician
  • Los Angeles, CA
  • NPI 1518309368
  Medicare reassignment NPD
• WT Health of California LLC

  • Infectious Disease Physician
  • Los Angeles, CA
  • NPI 1063201655
  Medicare reassignment NPD
• Lifebridge Community Physicians, Inc

  • Cardiovascular Disease Physician
  • Timonium, MD
  • NPI 1174815807
  Medicare reassignment
• El-Bershawi Medical Corp

  dba Pacific Pulmonary Medical Group

  • Critical Care Medicine (Internal Medicine) Physician
  • Riverside, CA
  • NPI 1386813103
  Medicare reassignment
• Lifebridge Community Physicians Inc

  • Cardiovascular Disease Physician
  • Lutherville, MD
  • NPI 1740086149
  NPD
• Lifebridge Community Physicians, Inc.

  dba Dr. Anisa Mirza

  • Internal Medicine Physician
  • Towson, MD
  • NPI 1508225798
  NPD
• Coastline Medical Walk in Center

  • Urgent Care Clinic/Center
  • Milton, DE
  • NPI 1710118088
  NPD
• Pacific Professional Surgical Group Inc

  • Trauma Surgery Physician
  • Riverside, CA
  • NPI 1578341608
  NPD (past)

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1992952170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6311 MARY THERESA CT",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210760000",
            "telephone_number": "302-430-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6311 MARY THERESA CT",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210761028",
            "telephone_number": "302-430-1974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "PETER",
        "middle_name": "DONGIL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-19",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0000606",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "58763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chesapeake Orthopaedic & Sports Medicine Center
• Chesapeake Orthopaedic and Sports Medicine Center
• Chesapeake Urology Associates, LLC
• Gareth Leku Chia
• Brandon Chie
• Rebecca Rodriguez Cirri, STUDENT NP
• Paul Robert Clavelle, PH.D.
• Clinical Counseling Services, LLC
• Carla Cobbs
• Kathleen A Coggins, MS, CF-SLP

• Physician Assistant in Hanover, MD
• Providers in Hanover, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.