Individual provider Active NPI

Chang (Kenny) Jian Chen, FNP, BC

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1275625634
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F333761 Issued in NY
Practice address
2266 Cropsey Ave
Brooklyn, NY 11214-5706
Phone
(718) 266-6100
Fax
(718) 265-3344
NPI assigned
Sep 29, 2006
Last updated
Sep 27, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F333761 NY Primary

Addresses

Primary practice location

2266 Cropsey Ave
Brooklyn, NY 11214-5706

Mailing address

1832 84TH St
Brooklyn, NY 11214-2915
Phone (917) 282-7683

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040612000032 NY Practitioner - Nurse Practitioner 8426031121 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1740 84TH St
Brooklyn, NY 11214-2825
Phone (718) 885-8484

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
58.3 of 100Reported as group
Quality
0
Improvement activities
40
Cost
61.01

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F333761NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chen Chang Jian NP in Family Health PC CurrentSince Jan 14, 2013 Accepting new patients

Locations

1740 84th St
Brooklyn, NY 11214
Phone (718) 232-3666

Organizations & group practices 2

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1275625634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1832 84TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112142915",
            "telephone_number": "917-282-7683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2266 CROPSEY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112145706",
            "telephone_number": "718-266-6100",
            "fax_number": "718-265-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "CHANG (KENNY)",
        "middle_name": "JIAN",
        "name_prefix": "Mr.",
        "credential": "FNP, BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F333761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.