Individual provider Active NPI

Annie Chen

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1396270807
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
306717 Issued in NY
Practice address
1090 Amsterdam Ave FL 16
Suite 16a
New York, NY 10025-1737
Phone
(212) 523-5089
NPI assigned
Apr 23, 2017
Last updated
May 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 306717 NY Primary

Addresses

Primary practice location

1090 Amsterdam Ave FL 16
Suite 16a
New York, NY 10025-1737

Mailing address

1090 Amsterdam Ave FL 16
Suite 16a
New York, NY 10025-1737

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240405003510 NY Practitioner - Psychiatry 1759627052 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
306717NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince May 1, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince May 1, 2024 Accepting new patients
SLR Psychiatric Associates PastSince Jan 2, 2018 Accepting new patients
New York General Medical Services PC Past Accepting new patients

Locations

1090 Amsterdam Ave
Fl 16
New York, NY 10025
Phone (212) 523-5089

1425 Madison Ave
New York, NY 10029
Phone (212) 824-8150

150 E 42nd St
#2
New York, NY 10017

Organizations & group practices 4

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": "1492905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1396270807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 AMSTERDAM AVE FL 16",
            "address_2": "SUITE 16A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 AMSTERDAM AVE FL 16",
            "address_2": "SUITE 16A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251737",
            "telephone_number": "212-523-5089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "ANNIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-23",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "306717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.