Richard D Chen, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G78024 Issued in CA

Practice address

801 Marble Way
Petaluma, CA 94954-8594

Phone

(707) 636-4363

Fax

(844) 268-1466

NPI assigned

Mar 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 17, 2017 through Apr 17, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Bouch Medical Corporation

  • General Practice Physician
  • Sebastopol, CA
  • NPI 1720467962
  NPD (past)
• Hill Park Integrative Medical Center

  • General Practice Physician
  • Sebastopol, CA
  • NPI 1952755415
  NPD (past)

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1285602573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 MARBLE WAY",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949548594",
            "telephone_number": "707-636-4363",
            "fax_number": "844-268-1466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MARBLE WAY",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949548594",
            "telephone_number": "707-636-4363",
            "fax_number": "844-268-1466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "395 Pleasant St",
            "address_purpose": "LOCATION",
            "city": "Northampton",
            "state": "MA",
            "postal_code": "010603914",
            "country_code": "US",
            "telephone_number": "413-584-7787",
            "fax_number": "413-584-7778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "435 Petaluma Ave Ste 150",
            "address_purpose": "LOCATION",
            "city": "Sebastopol",
            "state": "CA",
            "postal_code": "95472",
            "country_code": "US",
            "telephone_number": "707-861-7300",
            "fax_number": "707-823-8568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "RICHARD",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CA",
            "license": "G78024",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G78024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Chavez
• Sunny T Chavez, CNA, MA
• Randell J. Cheek, MFT
• Iun-Iu A. Chen, D.O.
• Mina Chen, OD
• Lauryn Chenoweth
• Cheryl Cherney, MT
• Derrick Cheroti
• Sebastian Chevrolet
• Carlin Li-an CHI, M.D.

• Family Medicine Physician in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.