Individual provider Active NPI

I Jen Chen, MD

  • Internal Medicine Physician
  • Seattle, WA
National Provider Identifier
1023187622
Registry record updated Jun 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00022361 Issued in WA
Practice address
10317 Greenwood Avenue N
Seattle, WA 98133-9152
Phone
(206) 297-6056
Fax
(206) 297-6059
NPI assigned
Nov 7, 2006
Last updated
Jun 22, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00022361 WA Primary

Addresses

Primary practice location

10317 Greenwood Avenue N
Seattle, WA 98133-9152

Mailing address

10317 Greenwood Avenue N
#202
Seattle, WA 98133-9152
Phone (206) 297-6056

Other identifiers 1

IdentifierTypeStateIssuer
1017870MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20100917000341 WA Practitioner - Internal MedicinePractitioner - Geriatric Medicine 2769493774 Practice locations: Bellevue, WA

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9951 Lake Washington Blvd NE
Apt 36
Bellevue, WA 98004-6012
Phone (206) 234-7377

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00022361WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kin on Health Care Center Past Accepting new patients

Organizations & group practices 1

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277164800000",
    "number": "1023187622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10317 GREENWOOD AVENUE N",
            "address_2": "#202",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981339152",
            "telephone_number": "206-297-6056",
            "fax_number": "206-297-6059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10317 GREENWOOD AVENUE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981339152",
            "telephone_number": "206-297-6056",
            "fax_number": "206-297-6059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "I JEN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2010-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00022361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1017870",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.