Individual provider Active NPI

Jingjing Chen, MD

  • Pulmonary Disease Physician
  • Phoenix, AZ
National Provider Identifier
1205331345
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
69076 Issued in AZ
Practice address
5777 E Mayo Blvd
Phoenix, AZ 85054-4502
Phone
(480) 515-6296
NPI assigned
Mar 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0094073 MD
Student in an Organized Health Care Education/Training Program 390200000X
Pulmonary Disease Physician 207RP1001X 69076 AZ Primary

Addresses

Primary practice location

5777 E Mayo Blvd
Phoenix, AZ 85054-4502

Mailing address

355 Bard Ave Dept of Medicine Villa BLDG 1St Floor
Staten Island, NY 10310-1664
Phone (718) 818-2419

Other practice location 1

201 E University Pkwy
Baltimore, MD 21218-2829
Phone (410) 554-2284

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jchen1958732@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220611000427 MD Practitioner - Internal Medicine 1759769284 Reassigns benefits to 1 organization
I20230422000081 DC Practitioner - Internal Medicine 1759769284 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0094073MDMDInternal Medicine Physician
69076AZMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Jun 1, 2022 Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

201 E University Pkwy
Baltimore, MD 21218
Phone (410) 554-2651

18101 Prince Philip Dr
Olney, MD 20832
Phone (301) 774-8618

9000 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 682-7000

Interoperability endpoints

  • Direct secure messaging: jchen1958732@ehrdirect.mayoclinicmsg.org

Organizations & group practices 1

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": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1205331345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 BARD AVE DEPT OF MEDICINE VILLA BLDG 1ST FLOOR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101664",
            "telephone_number": "718-818-2419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5777 E MAYO BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850544502",
            "telephone_number": "480-515-6296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 E University Pkwy",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212182829",
            "country_code": "US",
            "telephone_number": "410-554-2284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "JINGJING",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0094073",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AZ",
            "license": "69076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jchen1958732@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "5777 E Mayo Blvd",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850544502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.