DR. CHONG S CHA (M.D.) – General Practice Physician, NPI 1417955758

DR. CHONG S CHA (M.D.) is a healthcare provider. based in Upper sandusky, Ohio. specializing in General Practice Physician. They hold the professional credentials M.D.. They hold a License No. 35-040362 (OH). The NPI Number for DR. CHONG S CHA (M.D.) is 1417955758

Main info

Male
60 Years Of Experience
Accepts Medicare Assignment
Name
DR. CHONG S CHA (M.D.)
NPI
1417955758
Phone
(419) 294-5358
Address
885 N SANDUSKY AVE
Enumeration Date
11 July 2005
Last Update Date
15 August 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4199030404
Graduation Year
1966 (60 years ago)
PAC ID
6406957299
Group Practice PAC ID
5092980730
Professional Enrollment ID
I20070724000210
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for DR. CHONG S CHA (M.D.)

  • Wyandot Memorial Hospital, 885, North Sandusky Avenue, Upper Sandusky, Crane Township, Wyandot County, Ohio, 43351, United States

    UPPER SANDUSKY, OH 433511031

    Phone: (419) 294-5358

    Fax: (419) 294-3221

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2007-07-24

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
I20070724000210IGeneral PracticeOHTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes1818$0
View full utilization report →

Insurance plans in this area (ZIP 43351)

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Provider's Procedures

DR. CHONG S CHA (M.D.) performs procedures in General Practice Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
GENERAL PRACTICEOH81002Urinalysis, manual test1111

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: 5092980730View full group profile
NameSpecialtyState
Internal MedicineMI
-OH
-OH
-OH
Nurse PractitionerOH
Nurse PractitionerOH
Nurse PractitionerOH
-OH
Pediatric MedicineOH
Nurse PractitionerOH

Reviews

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Frequently asked questions

Can I verify DR. CHONG S CHA (M.D.) with an NPI only?
You can start verification with NPI 1417955758 for DR. CHONG S CHA (M.D.), then check state licensing separately.
Does CMS list DR. CHONG S CHA (M.D.) as active?
Yes — DR. CHONG S CHA (M.D.) is active in the NPI listing used on this page.
What is DR. CHONG S CHA (M.D.)'s primary classification?
General Practice Physician is the headline specialty for DR. CHONG S CHA (M.D.) here. Clinical services aligned with this taxonomy classification.
Where is DR. CHONG S CHA (M.D.) based?
DR. CHONG S CHA (M.D.) is tied to Upper Sandusky, Ohio in the data we show; additional addresses may exist on the full record.
Why does DR. CHONG S CHA (M.D.) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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