Organization Active NPI

Park Avenue OB/GYN P.C

  • Specialist
  • New York, NY
National Provider Identifier
1215157672
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
212677-1 Issued in NY
Legal business name
PARK AVENUE OB/GYN P.C
Practice address
1112 Park Ave
New York, NY 10128-1235
Phone
(212) 369-8192
NPI assigned
Apr 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Dr. Hsiang ChenNPI 1528038908
Title
Doctor
Phone
(212) 369-8192

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 212677-1 NY Primary

Addresses

Primary practice location

1112 Park Ave
New York, NY 10128-1235

Mailing address

1112 Park Ave
New York, NY 10128-1235
Phone (212) 369-8192

Other practice location 1

1125 Park Ave
New York, NY 10128-1243
Phone (212) 369-8192

Other identifiers 1

IdentifierTypeStateIssuer
01921686MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070511000522 NY Part B Supplier - Clinic/Group Practice 9931206737 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1072447Park Avenue OB/GYN PC1112 Park Avenue, New York, NY 10128Certificate of waiverAug 15, 2027

National Provider Directory

National Provider Directory

Locations

333 Jericho Tpke
Ste 102
Jericho, NY 11753
Phone (516) 937-9100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1215157672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101281235",
            "telephone_number": "212-369-8192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101281235",
            "telephone_number": "212-369-8192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 Park Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "101281243",
            "country_code": "US",
            "telephone_number": "212-369-8192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PARK AVENUE OB/GYN P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "HSIANG",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "212-369-8192",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "212677-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01921686",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.