Active NPI
Jim C Chen, M.D.
- Geriatric Psychiatry Physician
- Bellevue, WA
National Provider Identifier
1295846012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Psychiatry Physician
- License
- MD00031641
- Practice address
- 1 Lake Bellevue Dr
Suite #101
Bellevue, WA 98005-2417 - Phone
- (206) 354-0603
- Fax
- (425) 454-4556
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Psychiatry Physician | 2084P0805X | MD00031641 | WA | Primary |
Addresses
Primary practice location
1 Lake Bellevue Dr
Suite #101
Bellevue, WA 98005-2417
Mailing address
1 Lake Bellevue Dr
Suite #101
Bellevue, WA 98005-2417
Phone (206) 354-0603
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8221277 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 7, 2021 through Apr 7, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00031641 | WA | MD | Geriatric Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328572800000",
"number": "1295846012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 LAKE BELLEVUE DR",
"address_2": "SUITE #101",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980052417",
"telephone_number": "206-354-0603",
"fax_number": "425-454-4556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 LAKE BELLEVUE DR",
"address_2": "SUITE #101",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980052417",
"telephone_number": "206-354-0603",
"fax_number": "425-454-4556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEN",
"first_name": "JIM",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2012-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0805X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Geriatric Psychiatry",
"state": "WA",
"license": "MD00031641",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8221277",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.