NPIMap

Individual provider Active NPI

Aerie Chung, MD

  • Infectious Disease Physician
  • Mishawaka, IN
National Provider Identifier
1992960850
Registry record updated Jul 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
01072481A Issued in IN
Practice address
3838 N Main St Ste 1C
Mishawaka, IN 46545-3100
Phone
(574) 404-3980
Fax
(574) 931-8601
NPI assigned
Jul 21, 2008
Last updated
Jul 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301091941 MI
Infectious Disease Physician 207RI0200X 18339 WI
Infectious Disease Physician 207RI0200X 01072481A IN Primary

Addresses

Primary practice location

3838 N Main St Ste 1C
Mishawaka, IN 46545-3100

Mailing address

3838 N Main St Ste 1C
Mishawaka, IN 46545-3100
Phone (574) 404-3980

Other identifiers 3

IdentifierTypeStateIssuer
1877200008OtherINMEDICARE
201163410MedicaidIN
P01703901OtherINRR MEDICARE

Other names 1

  • Won K Chung Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, NE2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131015002195 IN Practitioner - Infectious DiseasePractitioner - Internal Medicine 5991939415 Reassigns benefits to 2 organizations
I20230810001321 NE Practitioner - Infectious Disease 5991939415 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3838 N Main St
1C
Mishawaka, IN 46545-3100

611 W Francis St
200 Great Plains Health Outpatient Services
North Platte, NE 69101-0614
Phone (308) 568-3500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301091941MIMDInternal Medicine Physician
01072481AINMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Platte Nebraska Hospital Corporation Internal Medicine CurrentSince Jul 27, 2023 Accepting new patients
Regional West Physicians Clinic Internal Medicine CurrentSince Jul 8, 2024 Accepting new patients
Mids, LLC Internal Medicine CurrentSince Aug 8, 2019 Accepting new patients
Chadron Community Hospital Corp. Current Accepting new patients
North Platte Nebraska Hospital Corporation Current Accepting new patients
Major Hospital Past Accepting new patients
Michigan State University Kalamazoo Center for Medical Studies Past Accepting new patients

Locations

3838 N Main St
Ste 1C
Mishawaka, IN 46545
Phone (574) 286-6802

825 Centennial Dr
Chadron, NE 69337
Phone (308) 432-4441

601 W Leota St
North Platte, NE 69101
Phone (308) 534-2288

611 W Francis St
Ste 200
North Platte, NE 69101
Phone (308) 534-9230

Interoperability endpoints

  • Direct secure messaging: won.chung@140675705667588.direct.elationemr.com

Organizations & group practices 7

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.

Hospital & facility affiliations 5

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": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688169600000",
    "number": "1992960850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 N MAIN ST STE 1C",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453100",
            "telephone_number": "574-404-3980",
            "fax_number": "574-931-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 N MAIN ST STE 1C",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453100",
            "telephone_number": "574-404-3980",
            "fax_number": "574-931-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "AERIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-21",
        "last_updated": "2023-07-01",
        "certification_date": "2023-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301091941",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "WI",
            "license": "18339",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IN",
            "license": "01072481A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1877200008",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201163410",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01703901",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WON",
            "last_name": "CHUNG",
            "middle_name": "K",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.