Individual provider Active NPI

John C Chen, M

  • Diagnostic Radiology Physician
  • Mount Kisco, NY
National Provider Identifier
1407872914
Registry record updated Nov 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
223534 Issued in NY
Practice address
90 S Bedford Rd
Care Mount Medical PC
Mount Kisco, NY 10549-3412
Phone
(914) 241-1050
Fax
(914) 242-1516
NPI assigned
Jul 15, 2006
Last updated
Nov 11, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 223534 NY Primary

Addresses

Primary practice location

90 S Bedford Rd
Care Mount Medical PC
Mount Kisco, NY 10549-3412

Mailing address

110 S Bedford Rd
Care Mount Medical PC
Mount Kisco, NY 10549-3446
Phone (914) 241-1050

Other identifiers 4

IdentifierTypeStateIssuer
00547351MedicaidNY
0667910001OtherNYDME
02600291MedicaidNY
P00370680OtherNYMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050927000779 NY Practitioner - Diagnostic Radiology 5698750016 Reassigns benefits to 2 organizations
I20221031002236 NJ Practitioner - Diagnostic Radiology 5698750016 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
223534NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Feb 19, 2007 Accepting new patients
A.G. Dikengil, MD, PA CurrentSince Oct 1, 2022 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Aug 2, 2023 Accepting new patients
Optum Urgent Care, PLLC CurrentSince Mar 1, 2025 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Aug 2, 2023 Accepting new patients
Optum Medical Care, P.C. Diagnostic Radiology CurrentSince Feb 19, 2007 Accepting new patients

Locations

935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012

736 Page Ave
Lyndhurst, NJ 07071
Phone (201) 531-9006

1 Harmon Plz
Fl 10
Secaucus, NJ 07094
Phone (201) 636-7233

2322 30th Ave
Astoria, NY 11102
Phone (718) 267-2763

185 Route 312
Brewster, NY 10509
Phone (845) 278-4300

555 N Broadway
Jericho, NY 11753
Phone (516) 597-5070

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

Philadelphia, PA 19195

Networks

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

Organizations & group practices 6

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": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478822400000",
    "number": "1407872914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S BEDFORD RD",
            "address_2": "CARE MOUNT MEDICAL PC",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493446",
            "telephone_number": "914-241-1050",
            "fax_number": "914-242-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 S BEDFORD RD",
            "address_2": "CARE MOUNT MEDICAL PC",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493412",
            "telephone_number": "914-241-1050",
            "fax_number": "914-242-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "JOHN",
        "middle_name": "C",
        "credential": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2016-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "223534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00547351",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "0667910001",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02600291",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00370680",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Kisco, NY

Sources for this page

Verify at the official NPI Registry.