Individual provider Active NPI

Jennifer Hinlu Chuang, MD

  • Pediatric Adolescent Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1053557504
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
MD446677 Issued in PA
Practice address
3401 Civic Center Blvd
Children'S Hospital of Philadelphia - Adolescent Med
Philadelphia, PA 19104-4319
Phone
(215) 590-6864
Fax
(215) 590-4708
NPI assigned
Jan 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 25MA10350700 NJ
Pediatric Adolescent Medicine Physician 2080A0000X MD446677 PA Primary

Addresses

Primary practice location

3401 Civic Center Blvd
Children'S Hospital of Philadelphia - Adolescent Med
Philadelphia, PA 19104-4319

Mailing address

703 Main St
Paterson, NJ 07503-2621
Phone (973) 754-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20121003000043 PA Practitioner - Pediatric Medicine 3173772423 Reassigns benefits to 1 organization
I20200113000735 NJ Practitioner - Pediatric Medicine 3173772423 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA10350700NJMDPediatric Adolescent Medicine Physician
MD446677PAMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph'S Healthcare, Inc. CurrentSince Nov 23, 2019 Accepting new patients
Childrens Health Care Associates, Inc CurrentSince Aug 5, 2012 Accepting new patients
Childen'S Health Care Associates Inc. CurrentSince Aug 5, 2012 Accepting new patients
St Josephs Medical Group PC CurrentSince Nov 1, 2021 Accepting new patients
St Josephs University Medical Center Inc. Past Accepting new patients

Locations

703 Main St
Rm XG2126
Paterson, NJ 07503
Phone (973) 754-2240

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

703 Main St
#G
Paterson, NJ 07503
Phone (973) 754-6331

703 Main St
Bldg 400
Paterson, NJ 07503
Phone (973) 754-2054

220 Hamburg Tpke
Ste 203
Wayne, NJ 07470

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1231113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1053557504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621",
            "telephone_number": "973-754-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "CHILDREN'S HOSPITAL OF PHILADELPHIA - ADOLESCENT MED",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-6864",
            "fax_number": "215-590-4708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUANG",
        "first_name": "JENNIFER",
        "middle_name": "HINLU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-05",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NJ",
            "license": "25MA10350700",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "PA",
            "license": "MD446677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.