DR. CHAE WON IM (MD) – Psychiatry Physician, NPI 1063041978

DR. CHAE WON IM (MD) is a healthcare provider. based in Hilo, Hawaii. specializing in PSYCHIATRY. They hold the professional credentials MD. They hold a License No. MD24308 (HI). The NPI Number for DR. CHAE WON IM (MD) is 1063041978

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
DR. CHAE WON IM (MD)
NPI
1063041978
Phone
Not provided
Address
1190 WAIANUENUE AVE
Enumeration Date
2 April 2020
Last Update Date
31 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8089323000
Graduation Year
2020 (6 years ago)
PAC ID
7416370424
Group Practice PAC ID
1254422900
Professional Enrollment ID
I20240819001897
Address ID
HI967202089HI1190XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:6State licenses:1Digital endpointsOther names

832 PSYCHIATRY in GA

Provider Addresses for DR. CHAE WON IM (MD)

  • 1190 WAIANUENUE AVE

    HILO, HI 967202089

    Phone:

    Type: Mailing

  • 201 DOWMAN DR NE

    ATLANTA, GA 303221007

    Phone: (404) 727-6123

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 11 Open Payments records for all available years, with a total value of $343.

Total Amount is formed as General ($343) + Research ($0) + Ownership ($0) = $343.

Last reported payment date: 2024-12-20 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($167).

Total Amount

$343

General + Research + Ownership

Payments

11

Total payment records

General Amount

$343

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-20

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-08-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240819001897IPsychiatryHITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 96720)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1254422900View full group profile
NameSpecialtyState
General SurgeryHI
Clinical Social WorkerAK
Family PracticeTN
-IL
A N E S T H E S I O L O G YMA
Nurse PractitionerHI
Internal Medicine, Cardiovascular Disease (Cardiology), Interventional CardiologyWA
A N E S T H E S I O L O G YHI
Interventional Cardiology, Cardiovascular Disease (Cardiology)TX
U R O L O G YHI

Reviews

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Frequently asked questions

Does DR. CHAE WON IM (MD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. CHAE WON IM (MD) uses 1063041978.
Does the file indicate DR. CHAE WON IM (MD) is practicing under active NPI?
Directory data currently reports DR. CHAE WON IM (MD) as active.
What healthcare role does DR. CHAE WON IM (MD) hold?
Scheduling teams often label DR. CHAE WON IM (MD) under Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Where is DR. CHAE WON IM (MD) based?
DR. CHAE WON IM (MD) is tied to Hilo, Hawaii in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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