Individual provider Active NPI

Kevin Siwei Chen

  • Physician Assistant
  • Corona, CA
National Provider Identifier
1184269284
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
57501 Issued in CA
Practice address
341 Magnolia Ave Ste 201
Corona, CA 92879-3332
Phone
(951) 735-6969
NPI assigned
Nov 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 57501 CA Primary

Addresses

Primary practice location

341 Magnolia Ave Ste 201
Corona, CA 92879-3332

Mailing address

341 Magnolia Ave Ste 201
Corona, CA 92879-3332
Phone (951) 735-6969

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221201001621 CA Practitioner - Physician Assistant 8820466451 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
57501CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Aspen Medical Group, Inc. Physician Assistant CurrentSince Aug 18, 2022 Accepting new patients
Aspen Medical Group, Inc Physician Assistant Past Accepting new patients

Locations

341 Magnolia Ave
Ste 201
Corona, CA 92879
Phone (951) 735-6969

11441 Heacock St
Ste B1
Moreno Valley, CA 92557
Phone (909) 924-1906

9041 Magnolia Ave
Ste 305
Riverside, CA 92503
Phone (951) 343-3477

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1573516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1184269284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 MAGNOLIA AVE STE 201",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793332",
            "telephone_number": "951-735-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 MAGNOLIA AVE STE 201",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793332",
            "telephone_number": "951-735-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "KEVIN",
        "middle_name": "SIWEI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-12",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.