Individual provider Active NPI

George Chen

  • Physical Therapist
  • San Leandro, CA
National Provider Identifier
1275558256
Registry record updated Nov 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT21731 Issued in CA
Practice address
433 Estudillo Ave
San Leandro, CA 94577-4915
Phone
(510) 351-9198
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC8251 CA
Physical Therapist 225100000X PT21731 CA Primary

Addresses

Primary practice location

433 Estudillo Ave
San Leandro, CA 94577-4915

Mailing address

6575 Ridgewood Dr
Castro Valley, CA 94552-5205
Phone (510) 351-9198

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051228000573 CA Practitioner - Physical Therapist in Private Practice 7113949611 Practice locations: San Leandro, CA

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

433 Estudillo Ave
Suite 301
San Leandro, CA 94577-4915
Phone (510) 351-9198

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AC8251CAMDAcupuncturist
PT21731CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
George Chen Physical Therapist PastSince Apr 25, 2013 Accepting new patients

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354147200000",
    "number": "1275558256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6575 RIDGEWOOD DR",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945525205",
            "telephone_number": "510-351-9198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 ESTUDILLO AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774915",
            "telephone_number": "510-351-9198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "GEORGE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2012-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC8251",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT21731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2012; 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.