Individual provider Active NPI

Peter C Chen, M.D.

  • Ophthalmology Physician
  • New York, NY
National Provider Identifier
1114999349
Registry record updated May 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
127821 Issued in NY
Practice address
81 Elizabeth St # 402
New York, NY 10013-4729
Phone
(212) 431-3655
Fax
(212) 431-4045
NPI assigned
Feb 2, 2006
Last updated
May 18, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 127821 NY Primary

Addresses

Primary practice location

81 Elizabeth St # 402
New York, NY 10013-4729

Mailing address

81 Elizabeth St # 402
New York, NY 10013-4729
Phone (212) 431-3655

Other identifiers 1

IdentifierTypeStateIssuer
00277876MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040601001395 NY Practitioner - Ophthalmology 6507848983 Practice locations: New York, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
127821NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431907200000",
    "number": "1114999349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 ELIZABETH ST # 402",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134729",
            "telephone_number": "212-431-3655",
            "fax_number": "212-431-4045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 ELIZABETH ST # 402",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134729",
            "telephone_number": "212-431-3655",
            "fax_number": "212-431-4045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "PETER",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2015-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "127821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00277876",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.