Individual provider Active NPI

Elaine Chen

  • Surgical Physician Assistant
  • West Covina, CA
National Provider Identifier
1083248587
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
741 S Orange Ave FL 2
West Covina, CA 91790-2662
Phone
(626) 338-7391
NPI assigned
Feb 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-007643 IL
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

741 S Orange Ave FL 2
West Covina, CA 91790-2662

Mailing address

741 S Orange Ave FL 2
West Covina, CA 91790-2662
Phone (626) 338-7391

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210322001275 CA Practitioner - Physician Assistant 5193142594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samimi Orthopedic Group IncGroup PAC ID 0547208746, 9 clinicians

Practice addresses (Care Compare)

970 S Village Oaks Dr
Suite 100
Covina, CA 91724-3626
Phone (800) 974-5633

Hospital & facility affiliations

  • Emanate Health Inter-Community Hospital Hospital, Covina, CA, CCN 050382

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
58899CAMDDentist
085-007643ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Payam Vahedifar MD Inc Past Accepting new patients

Organizations & group practices 2

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 3

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": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1083248587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 S ORANGE AVE FL 2",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902662",
            "telephone_number": "626-338-7391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 S ORANGE AVE FL 2",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902662",
            "telephone_number": "626-338-7391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "ELAINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-24",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-007643",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.