Active NPI
Mary Chen, O.D.
- Optometrist
- New York, NY
National Provider Identifier
1518166990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 007176
- Practice address
- 109 Lafayette St
4TH Floor
New York, NY 10013-4154 - Phone
- (212) 274-1900
- NPI assigned
- Jul 16, 2007
- Last updated
- May 22, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 007176 | NY | Primary |
Addresses
Primary practice location
109 Lafayette St
4TH Floor
New York, NY 10013-4154
Mailing address
109 Lafayette St
4TH Floor
New York, NY 10013-4154
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02912581 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007176 | NY | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| FS Optometry LLC | Past | Accepting new patients | |
| Raymond Fong MD, PC | Past | Accepting new patients |
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.
-
- Ophthalmology Physician
- Flushing, NY
- NPI 1619196516
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211414400000",
"number": "1518166990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 LAFAYETTE ST",
"address_2": "4TH FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100134154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 LAFAYETTE ST",
"address_2": "4TH FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100134154",
"telephone_number": "212-274-1900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEN",
"first_name": "MARY",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-16",
"last_updated": "2008-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "007176",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02912581",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.