Individual provider Active NPI

Jeffery Yin-Tei Chen, NP-C

  • Family Nurse Practitioner
  • Glen Cove, NY
National Provider Identifier
1093470411
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F11210029 Issued in MI
Practice address
101 Saint Andrews LN
Glen Cove, NY 11542-2254
Phone
(516) 674-7300
NPI assigned
Nov 1, 2021
Last updated
May 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F11210029 MI Primary

Addresses

Primary practice location

101 Saint Andrews LN
Glen Cove, NY 11542-2254

Mailing address

101 Saint Andrews LN
Glen Cove, NY 11542-2254

Other practice location 1

24455 61st Ave
Little Neck, NY 11362-1934
Phone (734) 709-5734

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240531000848 NY Practitioner - Nurse Practitioner 5698117919 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F11210029MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince May 28, 2024 Accepting new patients

Locations

101 Saint Andrews Ln
Glen Cove, NY 11542
Phone (516) 674-7300

300 Community Dr
Manhasset, NY 11030

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1093470411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SAINT ANDREWS LN",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SAINT ANDREWS LN",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422254",
            "telephone_number": "516-674-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24455 61st Ave",
            "address_purpose": "LOCATION",
            "city": "Little Neck",
            "state": "NY",
            "postal_code": "113621934",
            "country_code": "US",
            "telephone_number": "734-709-5734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "JEFFERY",
        "middle_name": "YIN-TEI",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-01",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "F11210029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

Verify at the official NPI Registry.