Individual provider Active NPI

Travis Justin Chen, MD

  • Family Medicine Physician
  • Fresno, CA
National Provider Identifier
1104403914
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A196727 Issued in CA
Practice address
1221 E Spruce Ave
Fresno, CA 93720-3374
Phone
(559) 450-5777
Fax
(556) 450-5687
NPI assigned
Mar 26, 2021
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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 A196727 CA Primary

Addresses

Primary practice location

1221 E Spruce Ave
Fresno, CA 93720-3374

Mailing address

1111 E Spruce Ave Ste 431
Fresno, CA 93720-3330
Phone (559) 450-5611

Other practice location 1

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 639-2000

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240703002533 CA Practitioner - Family Practice 3072916170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in New Orleans, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Agnes Medical FoundationGroup PAC ID 7618946369, 161 clinicians

Practice addresses (Care Compare)

1221 E Spruce Ave
Fresno, CA 93720-3374
Phone (559) 450-5777

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.57 of 100Reported as group
Quality
63.43
Promoting interoperability
98
Improvement activities
40
Cost
77.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A196727CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LQMG Medical Group Inc. Current Accepting new patients
Saint Agnes Medical Foundation Family Medicine CurrentSince Jun 1, 2024 Accepting new patients

Locations

1111 E Spruce Ave
Ste 431
Fresno, CA 93720
Phone (559) 450-5611

1221 E Spruce Ave
Fresno, CA 93720
Phone (559) 449-5777

4770 W Herndon Ave
Ste 107
Fresno, CA 93722
Phone (559) 450-6310

Interoperability endpoints

  • Direct secure messaging: tchen3578624@direct.trinity-health.org
  • Direct secure messaging: travis.chen@hca5.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1104403914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E SPRUCE AVE STE 431",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203330",
            "telephone_number": "559-450-5611",
            "fax_number": "559-450-7470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 E SPRUCE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203374",
            "telephone_number": "559-450-5777",
            "fax_number": "556-450-5687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 Kingsley Ave",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320735148",
            "country_code": "US",
            "telephone_number": "904-639-2000",
            "fax_number": "904-639-2015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "TRAVIS",
        "middle_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-26",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A196727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.