Individual provider Active NPI

Eugene Chin

  • Acute Care Nurse Practitioner
  • Long Island City, NY
National Provider Identifier
1154903789
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
431993 Issued in NY
Practice address
1102 49TH Ave Apt 2G
Long Island City, NY 11101-5658
Phone
(718) 887-1338
NPI assigned
Apr 23, 2021
Last updated
Apr 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 431993 NY Primary

Addresses

Primary practice location

1102 49TH Ave Apt 2G
Long Island City, NY 11101-5658

Mailing address

1102 49TH Ave Apt 2G
Long Island City, NY 11101-5658

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211103001442 NY Practitioner - Nurse Practitioner 3072901479 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adirondack Medical CenterGroup PAC ID 9638081284, shared by 8 NPIs, 85 clinicians

Practice addresses (Care Compare)

2233 State Route 86
Saranac Lake, NY 12983-5644
Phone (518) 891-4141

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
431993NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adirondack Medical Center CurrentSince Apr 22, 2022 Accepting new patients
Adirondack Medical Center CurrentSince Jan 28, 2023 Accepting new patients
Adirondack Medical Center CurrentSince Apr 22, 2022 Accepting new patients

Locations

2233 State Route 86
Saranac Lake, NY 12983
Phone (518) 891-4141

7 Stetson Rd
Tupper Lake, NY 12986
Phone (518) 359-7000

Organizations & group practices 3

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 2

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": "1619136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1154903789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 49TH AVE APT 2G",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111015658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 49TH AVE APT 2G",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111015658",
            "telephone_number": "718-887-1338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN",
        "first_name": "EUGENE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-23",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "431993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

Verify at the official NPI Registry.