Individual provider Active NPI

Jerrald Jingyi Chen, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Wilmington, DE
National Provider Identifier
1356760714
Registry record updated Feb 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
C1-0013714 Issued in DE
Practice address
2801 W 6TH St
Wilmington, DE 19805-1828
Phone
(302) 655-6135
NPI assigned
Apr 14, 2014
Last updated
Feb 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 25MA10356700 NJ
Physical Medicine & Rehabilitation Physician 208100000X C1-0013714 DE Primary

Addresses

Primary practice location

2801 W 6TH St
Wilmington, DE 19805-1828

Mailing address

78 Hilltop Blvd
East Brunswick, NJ 08816-2836
Phone (609) 235-5487

Other practice location 1

550 1st Ave
NYU Langone Medical Center
New York, NY 10016-6402
Phone (212) 263-5506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200702000328 DE Practitioner - Physical Medicine and Rehabilitation 3870820541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Pennsylvania State University College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golden Oak Medical LLCGroup PAC ID 4183964398, 4 clinicians

Practice addresses (Care Compare)

301 Ocean View Blvd
Lewes, DE 19958-1269
Phone (718) 598-6808

Merit-based Incentive Payment System (MIPS)

Final score
53.03 of 100Reported as individual
Quality
65
Improvement activities
0
Cost
56.77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C1-0013714DEMDPhysical Medicine & Rehabilitation Physician
25MA10356700NJMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Oak Medical LLC Physical Medicine & Rehabilitation CurrentSince Jun 26, 2020 Accepting new patients

Locations

301 Ocean View Blvd
Lewes, DE 19958
Phone (302) 645-4664

2801 W 6th St
Wilmington, DE 19805
Phone (302) 655-6135

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614384000000",
    "number": "1356760714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 HILLTOP BLVD",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088162836",
            "telephone_number": "609-235-5487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W 6TH ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198051828",
            "telephone_number": "302-655-6135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 1st Ave",
            "address_2": "NYU Langone Medical Center",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100166402",
            "country_code": "US",
            "telephone_number": "212-263-5506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "JERRALD",
        "middle_name": "JINGYI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-14",
        "last_updated": "2021-02-27",
        "certification_date": "2021-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "25MA10356700",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "DE",
            "license": "C1-0013714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.