Individual provider Active NPI

Jonathan Chen, OD

  • Optometrist
  • Atlanta, GA
National Provider Identifier
1154813525
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003194 Issued in GA
Practice address
5380 Roswell Rd
Atlanta, GA 30342-1916
Phone
(404) 250-1680
NPI assigned
Jun 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9821 TX
Optometrist 152W00000X OPT003194 GA Primary

Addresses

Primary practice location

5380 Roswell Rd
Atlanta, GA 30342-1916

Mailing address

5380 Roswell Rd
Atlanta, GA 30342-1916
Phone (404) 250-1680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, TX, GA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20180627001991 MO Practitioner - Optometry 4284980616 Reassigns benefits to 1 organization
I20200306000614 TX Practitioner - Optometry 4284980616 Reassigns benefits to 1 organization
I20221206003221 GA Practitioner - Optometry 4284980616 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Insight Eyecare PCGroup PAC ID 5294723227, 3 clinicians

Practice addresses (Care Compare)

5380 Roswell Rd
Atlanta, GA 30342-1916
Phone (404) 250-1680

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9821TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Med Southwest, PLLC Optometrist Current Accepting new patients
Curators of the University of Missouri Optometrist CurrentSince Jul 1, 2018 Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Jan 27, 2020 Accepting new patients
Curators of the University of Missouri CurrentSince Jul 1, 2018 Accepting new patients
Lawrenceville Eyecare LLC Optometrist CurrentSince Nov 14, 2024 Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Jan 27, 2020 Accepting new patients
Lakhani Vision Care, PC Optometrist Past Accepting new patients
Tonge Vision Group, P.C. Optometrist PastSince Nov 14, 2024 Accepting new patients

Locations

170 Camden Hill Rd
Ste B
Lawrenceville, GA 30046
Phone (406) 369-2020

7840 Natural Bridge Rd
Saint Louis, MO 63121
Phone (314) 382-6400

1 University Blvd
Saint Louis, MO 63121
Phone (314) 516-5131

6446 Lyndon B Johnson Fwy
Dallas, TX 75240
Phone (972) 960-2020

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1154813525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5380 ROSWELL RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421916",
            "telephone_number": "404-250-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5380 ROSWELL RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421916",
            "telephone_number": "404-250-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-01",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9821",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.