Individual provider Active NPI

Huanjing Chen, O.D.

  • Optometrist
  • Novato, CA
National Provider Identifier
1518377787
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
15252TLG Issued in CA
Practice address
1702 Novato Blvd
Novato, CA 94947-3049
Phone
(415) 897-9691
Fax
(650) 472-8995
NPI assigned
Apr 28, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T-212-TA-973 AL
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 15252TLG CA Primary

Addresses

Primary practice location

1702 Novato Blvd
Novato, CA 94947-3049

Mailing address

1702 Novato Blvd
Novato, CA 94947-3049
Phone (415) 897-9691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20151001002037 CA Practitioner - Optometry 5698990612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1702 Novato Blvd
Novato, CA 94947-3049
Phone (415) 897-9691

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15252TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jasmine Huanjing Chen O.D. a Professional Corporation Optometrist CurrentSince May 27, 2017 Accepting new patients
Total Vision PC Optometrist CurrentSince May 13, 2022 Accepting new patients

Locations

208 Vintage Way
Ste K21
Novato, CA 94945
Phone (415) 897-3377

1702 Novato Blvd
Novato, CA 94947
Phone (415) 897-9691

2366 El Camino Real
Ste 5
Santa Clara, CA 95050
Phone (408) 246-5858

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1518377787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 NOVATO BLVD",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949473049",
            "telephone_number": "415-897-9691",
            "fax_number": "650-472-8995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 NOVATO BLVD",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949473049",
            "telephone_number": "415-897-9691",
            "fax_number": "650-472-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "HUANJING",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-28",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "T-212-TA-973",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "15252TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novato, CA

Sources for this page

Verify at the official NPI Registry.