Individual provider Active NPI

David Chen

  • Surgical Physician Assistant
  • Long Island City, NY
National Provider Identifier
1376193086
Registry record updated Nov 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
023982 Issued in NY
Practice address
2510 30TH Ave
Long Island City, NY 11102-2448
Phone
(718) 932-1000
NPI assigned
Sep 14, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 023982 NY Primary

Addresses

Primary practice location

2510 30TH Ave
Long Island City, NY 11102-2448

Mailing address

2510 30TH Ave
Long Island City, NY 11102-2448

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
I20201021002381 NY Practitioner - Physician Assistant 3173943610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2510 30TH Ave
Astoria, NY 11102-2448
Phone (718) 932-1000

2520 30TH Ave
Astoria, NY 11102-2448
Phone (718) 808-7777

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
023982NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Jun 12, 2020 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jun 12, 2020 Accepting new patients

Locations

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

10114 Liberty Ave
#13292
Ozone Park, NY 11417
Phone (718) 487-3330

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1568419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574985600000",
    "number": "1376193086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 30TH AVE",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111022448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 30TH AVE",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111022448",
            "telephone_number": "718-932-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-14",
        "last_updated": "2019-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "023982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

Verify at the official NPI Registry.