Active NPI
Kimberly Chen
- Physician Assistant
- Cliffside Park, NJ
National Provider Identifier
1508449059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 11 Washington PL Apt 202
Cliffside Park, NJ 07010-1277 - Phone
- (917) 886-5038
- NPI assigned
- May 3, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
11 Washington PL Apt 202
Cliffside Park, NJ 07010-1277
Mailing address
11 Washington PL Apt 202
Cliffside Park, NJ 07010-1277
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260506002496 | NY | Order and Referring Only - Physician Assistant | 6507334737 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620000000000",
"number": "1508449059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 WASHINGTON PL APT 202",
"city": "CLIFFSIDE PARK",
"state": "NJ",
"postal_code": "070101277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 WASHINGTON PL APT 202",
"city": "CLIFFSIDE PARK",
"state": "NJ",
"postal_code": "070101277",
"telephone_number": "917-886-5038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEN",
"first_name": "KIMBERLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-03",
"last_updated": "2021-05-03",
"certification_date": "2021-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cliffside Park, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.