NPIMap

Individual provider Active NPI

Annie Bertha-Chao Chern, M.D.

  • Family Medicine Physician
  • San Jose, CA
National Provider Identifier
1104051507
Registry record updated Feb 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A107270 Issued in CA
Practice address
455 Oconnor Dr
Suite 210
San Jose, CA 95128-1633
Phone
(408) 995-5453
NPI assigned
May 29, 2009
Last updated
Feb 3, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A107270 CA Primary

Addresses

Primary practice location

455 Oconnor Dr
Suite 210
San Jose, CA 95128-1633

Mailing address

455 Oconnor Dr
Suite 210
San Jose, CA 95128-1633
Phone (408) 995-5453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110526000144 CA Practitioner - Family Practice 5890971972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Stanford University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Healthcare AllianceGroup PAC ID 6305748799, 334 clinicians

Practice addresses (Care Compare)

2410 Samaritan Dr
Suite 201
San Jose, CA 95124-3909
Phone (408) 371-9010

455 Oconnor Dr
Suite 210
San Jose, CA 95128-1632
Phone (408) 995-5453

50 E Hamilton Ave
Suite 280
Campbell, CA 95008-0273
Phone (408) 227-2646

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
107270CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
University Healthcare Alliance CurrentSince Oct 1, 2015 Accepting new patients
County of Santa Clara Past Accepting new patients
Affinity Medical Group Past Accepting new patients
Family Medicine Associates of San Jose Inc Family Medicine Past Accepting new patients

Locations

50 E Hamilton Ave
Ste 280
Campbell, CA 95008
Phone (408) 227-2646

455 Oconnor Dr
Ste 210
San Jose, CA 95128
Phone (408) 995-5453

Interoperability endpoints

  • Direct secure messaging: achern142929@direct.stanfordhealthcare.org
  • Direct secure messaging: achern41871@santaclaravalley.direct-ci.net

Organizations & group practices 4

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 9

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": "1243555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328227200000",
    "number": "1104051507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 OCONNOR DR",
            "address_2": "SUITE 210",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281633",
            "telephone_number": "408-995-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 OCONNOR DR",
            "address_2": "SUITE 210",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281633",
            "telephone_number": "408-995-5453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERN",
        "first_name": "ANNIE",
        "middle_name": "BERTHA-CHAO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-29",
        "last_updated": "2012-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A107270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.