NPIMap

Individual provider Active NPI

Kevin Chen, MD

  • Cardiovascular Disease Physician
  • Appleton, WI
National Provider Identifier
1255727160
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
84179 Issued in WI
Practice address
1818 N Meade St
Appleton, WI 54911-3454
Phone
(920) 731-8900
NPI assigned
Apr 8, 2015
Last updated
Jun 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 61459 CT
Cardiovascular Disease Physician 207RC0000X 84179 WI Primary

Addresses

Primary practice location

1818 N Meade St
Appleton, WI 54911-3454

Mailing address

3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 731-8900

Other practice location 1

7028 N Vista St
San Gabriel, CA 91775-1136
Phone (626) 673-3919

Other practice location 2

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190806000124 CT Practitioner - Internal MedicinePractitioner - Hospitalist 9436486057 Reassigns benefits to 1 organization
I20240725002086 WI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9436486057 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
New York Medical College, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Froedtert Manitowoc Medical Group, LLCGroup PAC ID 2365836954, 156 clinicians
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

1081 E Johnson St
Fond Du Lac, WI 54935-8919
Phone (920) 367-6700

1414 N Taylor Dr
Sheboygan, WI 53081-1988
Phone (920) 320-2436

1650 S 41St St
Manitowoc, WI 54220-7316
Phone (920) 320-2011

1818 N Meade St
Appleton, WI 54911-3454
Phone (920) 735-7645

2300 Western Ave
Manitowoc, WI 54220-3712
Phone (920) 320-2011

2631 Eastern Ave
Plymouth, WI 53073-4270
Phone (920) 320-2436

3736 S Taylor Dr
Sheboygan, WI 53081-8432
Phone (920) 476-6300

800 Lakefront Way
Two Rivers, WI 54241-3301
Phone (920) 320-2011

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting12

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Internal Medicine CurrentSince Jul 9, 2019 Accepting new patients
Thedacare, Incorporated CurrentSince May 16, 2024 Accepting new patients
Froedtert Manitowoc Medical Group, LLC Internal Medicine CurrentSince Dec 2, 2024 Accepting new patients
Thedacare Medical Center - Shawano, Inc. Past Accepting new patients

Locations

20 York St
Unit CB2041
New Haven, CT 06510
Phone (203) 688-4741

20 York St
North Haven, CT 06510
Phone (203) 688-2433

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

2300 Western Ave
Manitowoc, WI 54220
Phone (920) 320-2011

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

1405 Mill St
New London, WI 54961
Phone (920) 531-2000

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

1414 N Taylor Dr
Sheboygan, WI 53081
Phone (920) 320-2011

Interoperability endpoints

  • Direct secure messaging: kchen159305@direct.ynhh.org
  • Direct secure messaging: kchen339387@direct.thedacare.org
  • Direct secure messaging: kchen846884@direct.froedtert.com

Organizations & group practices 4

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 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1255727160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-731-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 N MEADE ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549113454",
            "telephone_number": "920-731-8900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7028 N Vista St",
            "address_purpose": "LOCATION",
            "city": "San Gabriel",
            "state": "CA",
            "postal_code": "917751136",
            "country_code": "US",
            "telephone_number": "626-673-3919",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 York St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103220",
            "country_code": "US",
            "telephone_number": "203-688-4242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-08",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "61459",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "84179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9333 Imperial Hwy",
            "city": "Downey",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902422812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.