Individual provider Active NPI

Andrew Steven Chen

  • Internal Medicine Physician
  • Fontana, CA
National Provider Identifier
1053873646
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A182957 Issued in CA
Practice address
14050 Cherry Ave Ste C
Fontana, CA 92337-8312
Phone
(909) 823-5220
NPI assigned
Apr 2, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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 A182957 CA Primary

Addresses

Primary practice location

14050 Cherry Ave Ste C
Fontana, CA 92337-8312

Mailing address

14050 Cherry Ave Ste C
Fontana, CA 92337-8312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240604000043 CA Practitioner - Internal Medicine 3678800281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ohio State University College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14050 Cherry Ave
Suite C
Fontana, CA 92337-8312
Phone (909) 823-5220

Hospital & facility affiliations

  • San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew S. Chen, M.D., Inc. Internal Medicine CurrentSince Mar 25, 2024 Accepting new patients

Locations

14050 Cherry Ave
Ste C
Fontana, CA 92337
Phone (909) 823-5220

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: andrew.chen@hca3.eclinicaldirectplus.com
  • Direct secure messaging: andrew.chen@531934331994116.direct.elationemr.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1053873646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14050 CHERRY AVE STE C",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923378312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14050 CHERRY AVE STE C",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923378312",
            "telephone_number": "909-823-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "ANDREW",
        "middle_name": "STEVEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A182957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.