Individual provider Active NPI

Ellen H Chen, M.D.

  • Interventional Cardiology Physician
  • Coos Bay, OR
National Provider Identifier
1083654313
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MED-PHYS-LIC-45806 Issued in MT
Practice address
1775 Thompson Rd
Coos Bay, OR 97420-2198
Phone
(541) 269-8111
NPI assigned
Jun 7, 2006
Last updated
Mar 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD186722 OR
Cardiovascular Disease Physician 207RC0000X MD00047746 WA
Cardiovascular Disease Physician 207RC0000X 01077302A IN
Cardiovascular Disease Physician 207RC0000X MC-0231 ID
Interventional Cardiology Physician 207RI0011X MED-PHYS-LIC-45806 MT Primary
Interventional Cardiology Physician 207RI0011X MC-0231 ID
Interventional Cardiology Physician 207RI0011X MD00047746 WA

Addresses

Primary practice location

1775 Thompson Rd
Coos Bay, OR 97420-2198

Mailing address

PO Box 59028
Renton, WA 98058-2028
Phone (425) 656-5415

Other practice location 1

4011 Talbot Rd S
Suite 500
Renton, WA 98055-5773
Phone (425) 251-5110

Other practice location 2

415 6th St
Lewiston, ID 83501-2434
Phone (208) 750-7507

Other identifiers 6

IdentifierTypeStateIssuer
1015CHOtherWAREGENCE
0248026OtherWAL&I
201379160MedicaidIN
000001041073OtherINANTHEM PROVIDER NUMBER
8478695MedicaidWA
8951017OtherWACRIME VICTIMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, OR, ID, NV4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20160818000258 IN Practitioner - Cardiovascular Disease (Cardiology) 0042104523 Reassigns benefits to 1 organization
I20180815001585 OR Practitioner - Cardiovascular Disease (Cardiology) 0042104523 Reassigns benefits to 2 organizations
I20190823001421 ID Practitioner - Interventional Cardiology 0042104523 Reassigns benefits to 1 organization
I20190903001076 NV Practitioner - Cardiovascular Disease (Cardiology) 0042104523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Medical College of Wisconsin, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay Area Hospital DistrictGroup PAC ID 2163331000, 117 clinicians

Practice addresses (Care Compare)

1775 Thompson Rd
Coos Bay, OR 97420-2125
Phone (541) 269-8280

2650 N 17TH St
Coos Bay, OR 97420-2134
Phone (541) 269-8282

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD186722ORMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arnett Clinic, LLC CurrentSince Sep 1, 2016 Accepting new patients
St Joseph Hospital LLC CurrentSince Jul 1, 2019 Accepting new patients
Bay Area Hospital District CurrentSince Sep 28, 2020 Accepting new patients
Bay Area Hospital District CurrentSince Sep 28, 2020 Accepting new patients
Northeastern Nevada Physician Practices LLC CurrentSince Jul 15, 2019 Accepting new patients
Centennial Medical Group Inc. Cardiovascular Disease CurrentSince Jul 13, 2018 Accepting new patients
Arnett Clinic, LLC CurrentSince Sep 1, 2016 Accepting new patients
Northeastern Nevada Physician Practices LLC Cardiovascular Disease CurrentSince Jul 15, 2019 Accepting new patients
Arnett Clinic, LLC Current Accepting new patients
Osu Internal Medicine, LLC Past Accepting new patients
Radiology Inc Past Accepting new patients

Locations

Dept LA 25339
Pasadena, CA 91185

415 6th St
Lewiston, ID 83501
Phone (208) 750-7445

821 21st Ave
Lewiston, ID 83501
Phone (208) 799-3422

8016 Reliable Pkwy
Chicago, IL 60686

2600 Greenbush St
Lafayette, IN 47904

1995 Errecart Blvd
Ste 110
Elko, NV 89801
Phone (775) 738-8877

1995 Errecart Blvd
Ste 204
Elko, NV 89801
Phone (775) 738-0520

2001 Errecart Blvd
Elko, NV 89801
Phone (775) 738-5151

1775 Thompson Rd
Coos Bay, OR 97420
Phone (541) 269-8090

2650 N 17th St
Coos Bay, OR 97420
Phone (541) 267-5411

2700 NW Stewart Pkwy
Roseburg, OR 97471
Phone (541) 673-0611

2801 NW Mercy Dr
Ste 340
Roseburg, OR 97471
Phone (541) 677-2494

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Organizations & group practices 11

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.

Hospital & facility affiliations 7

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1083654313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 59028",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980582028",
            "telephone_number": "425-656-5415",
            "fax_number": "425-793-7458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 THOMPSON RD",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202198",
            "telephone_number": "541-269-8111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4011 Talbot Rd S",
            "address_2": "Suite 500",
            "address_purpose": "LOCATION",
            "city": "Renton",
            "state": "WA",
            "postal_code": "980555773",
            "country_code": "US",
            "telephone_number": "425-251-5110",
            "fax_number": "425-793-7376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "415 6th St",
            "address_purpose": "LOCATION",
            "city": "Lewiston",
            "state": "ID",
            "postal_code": "835012434",
            "country_code": "US",
            "telephone_number": "208-750-7507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "ELLEN",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "MD186722",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD00047746",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01077302A",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ID",
            "license": "MC-0231",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MT",
            "license": "MED-PHYS-LIC-45806",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "ID",
            "license": "MC-0231",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WA",
            "license": "MD00047746",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "1015CH",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0248026",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201379160",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000001041073",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8478695",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8951017",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coos Bay, OR

Sources for this page

Verify at the official NPI Registry.