Individual provider Active NPI

Jennifer Lyn Chen, O.D.

  • Optometrist
  • Frederick, MD
National Provider Identifier
1386857100
Registry record updated Jul 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1339 Issued in MD
Practice address
10534 Liberty Rd
Frederick, MD 21701-2626
Phone
(301) 304-0373
Fax
(301) 527-1040
NPI assigned
May 8, 2007
Last updated
Jul 26, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA1339 MD Primary

Addresses

Primary practice location

10534 Liberty Rd
Frederick, MD 21701-2626

Mailing address

10534 Liberty Rd
Frederick, MD 21701-2626
Phone (301) 304-0373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120608000304 MD Practitioner - Optometry 5496919185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Longmeadow Optical, LTDGroup PAC ID 1951420298, 2 clinicians

Practice addresses (Care Compare)

7420 Hayward Rd
Suite 202
Frederick, MD 21702-2509
Phone (301) 662-8866

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Longmeadow Optical, LTD Optometrist CurrentSince May 23, 2012 Accepting new patients
Longmeadow Optical Optometrist PastSince May 23, 2012 Accepting new patients

Locations

7420 Hayward Rd
Ste 202
Frederick, MD 21702
Phone (301) 662-8866

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.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280102400000",
    "number": "1386857100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10534 LIBERTY RD",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217012626",
            "telephone_number": "301-304-0373",
            "fax_number": "301-527-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10534 LIBERTY RD",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217012626",
            "telephone_number": "301-304-0373",
            "fax_number": "301-527-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "JENNIFER",
        "middle_name": "LYN",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2010-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.