Jack Chen, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

74190 Issued in MN

Practice address

2355 Hwy 36 W
Ste. 100
Roseville, MN 55113

Phone

(651) 292-2000

NPI assigned

Jun 18, 2017

Last updated

Jul 31, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND, MN, WI3 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 3

Specialty

Diagnostic Radiology

Education

Saint Louis University School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grand Itasca Clinic and HospitalGroup PAC ID 8123939550, 328 clinicians

Allina Health SystemGroup PAC ID 4587573613, shared by 87 NPIs, 3,844 clinicians

Altru Health SystemGroup PAC ID 1355251604, 675 clinicians

Lutheran Charity AssociationGroup PAC ID 2264341031, 168 clinicians

Marshfield Clinic IncGroup PAC ID 2264345206, 207 clinicians

Midwest Radiology PAGroup PAC ID 4486568482, 217 clinicians

Ridgeview Medical CenterGroup PAC ID 9234041997, 407 clinicians

Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

St. Joseph's Hospital and Health CenterGroup PAC ID 0547177560, shared by 3 NPIs, 157 clinicians

The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Range Regional Health ServicesGroup PAC ID 8022920024, 349 clinicians

Suburban Imaging LLCGroup PAC ID 4688564867, 142 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Regions Hospital Hospital, Saint Paul, MN, CCN 240106
• Lakeview Memorial Hospital Hospital, Stillwater, MN, CCN 240066
• Westfields Hospital and Clinic Hospital, New Richmond, WI, CCN 521345
• Amery Hospital & Clinic Hospital, Amery, WI, CCN 521308
• Hudson Hospital Hospital, Hudson, WI, CCN 521335

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations (25 of 46)

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.

• Fairview Express Care

  dba M Health Fairview Recovery Clinic

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment Care Compare group NPD
• Grand Itasca Clinic and Hospital

  • General Acute Care Hospital
  • Grand Rapids, MN
  • NPI 1669426631
  Medicare reassignment Care Compare group NPD
• Range Regional Health Services

  • Clinic/Center
  • Hibbing, MN
  • NPI 1669569265
  Medicare reassignment Care Compare group NPD
• Ridgeview Medical Center

  dba Ridgeview Medical Center CRNAs

  • Certified Registered Nurse Anesthetist
  • Waconia, MN
  • NPI 1528364429
  Medicare reassignment Care Compare group NPD
• Suburban Imaging, LLC

  • Radiology Clinic/Center
  • Roseville, MN
  • NPI 1427008937
  Medicare reassignment Care Compare group NPD
• The Duluth Clinic LTD

  dba Essentia Health Cloquet Clinic

  • Multi-Specialty Clinic/Center
  • Cloquet, MN
  • NPI 1902563638
  Medicare reassignment Care Compare group NPD
• Altru Health System

  dba Altru 1300 Columbia

  • Clinic/Center
  • Grand Forks, ND
  • NPI 1043309552

  Internal Medicine, MN

  Medicare reassignment Care Compare group NPD
• Lutheran Charity Association

  dba Jamestown Regional Medical Center Radiology

  • Diagnostic Radiology Physician
  • Jamestown, ND
  • NPI 1700038981

  MN

  Medicare reassignment Care Compare group NPD
• Marshfield Clinic Inc

  dba Marshfield Clinic Florida Teleradiology/Telehealth

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981

  Internal Medicine, MN

  Medicare reassignment Care Compare group NPD
• Midwest Radiology, PA

  • Diagnostic Radiology Physician
  • Roseville, MN
  • NPI 1952307175

  WI

  Medicare reassignment Care Compare group
• Allina Health System

  dba Allina Health Buffalo Specialty Clinic

  • Obstetrics & Gynecology Physician
  • Buffalo, MN
  • NPI 1295272342
  Medicare reassignment NPD
• Allina Health System

  dba Allina Health Annandale Clinic

  • Family Medicine Physician
  • Annandale, MN
  • NPI 1457657249
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lakeview Memorial Hospital Association Inc

  dba Lakeview Hospital

  • General Acute Care Hospital
  • Stillwater, MN
  • NPI 1538138003
  Care Compare affiliation
• Lakeview Memorial Hospital Association Inc

  • Land Ambulance
  • Stillwater, MN
  • NPI 1730213653

  Hospital

  Care Compare affiliation
• Regions Hospital

  dba Phamacy - Outpatient Hospital

  • Pharmacy
  • Saint Paul, MN
  • NPI 1013951748

  Hospital

  Care Compare affiliation
• Regions Hospital

  dba HealthPartners Specialty Center Woodbury

  • General Acute Care Hospital
  • Woodbury, MN
  • NPI 1104681105
  Care Compare affiliation
• Regions Hospital

  dba Regions Hospital Rehabilitation

  • Rehabilitation Clinic/Center
  • Saint Paul, MN
  • NPI 1134157092

  Hospital

  Care Compare affiliation
• Regions Hospital

  dba HealthPartners Surgery Center

  • General Acute Care Hospital
  • Saint Paul, MN
  • NPI 1306873872
  Care Compare affiliation
• Regions Hospital

  • General Acute Care Hospital
  • Saint Paul, MN
  • NPI 1629006457
  Care Compare affiliation
• Regions Hospital

  dba HealthPartners Cancer Care at Lakeview Hospital

  • General Acute Care Hospital
  • Stillwater, MN
  • NPI 1679391122
  Care Compare affiliation
• Regions Hospital

  dba HealthPartners Medical Transportation

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1871929976

  Hospital

  Care Compare affiliation
• Regions Hospital

  • General Acute Care Hospital
  • Coon Rapids, MN
  • NPI 1962149419
  Care Compare affiliation
• Amery Regional Medical Center, Inc.

  dba Amery Hospital & Clinic

  • Critical Access Hospital
  • Amery, WI
  • NPI 1093763518
  Care Compare affiliation
• Amery Regional Medical Center, Inc.

  dba Amery Hospital & Clinic -Clear Lake Clinic

  • Rural Health Clinic/Center
  • Clear Lake, WI
  • NPI 1366878449

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1104356500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 HWY 36 W.",
            "address_2": "STE. 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-292-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 HWY 36 W",
            "address_2": "STE. 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-292-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "JACK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-18",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "74190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David T Chang, MD
• Ta Linda Chang, LAC
• Micaela T Chatman, MD
• Doan Chau, PHARMD
• Keros Alexander Chavez
• Paul Chen Jr., M.D., PHARM.D.
• Cherrywood Pointe of Roseville at Lexington LLC
• Cherrywood Pointe of Roseville LLC
• Cherrywood Pointe of Roseville, LLC
• George V. Chesteen II, MD

• Diagnostic Radiology Physician in Roseville, MN
• Providers in Roseville, MN by specialty
• Diagnostic Radiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.