Individual provider Active NPI

Mary Chen, M.D.

  • Internal Medicine Physician
  • Walnut, CA
National Provider Identifier
1568445229
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A78207 Issued in CA
Practice address
18780 Amar Rd
Suite 107
Walnut, CA 91789-4560
Phone
(626) 810-6777
Fax
(626) 810-6687
NPI assigned
Nov 26, 2005
Last updated
Apr 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A78207 CA
Internal Medicine Physician 207R00000X A78207 CA Primary

Addresses

Primary practice location

18780 Amar Rd
Suite 107
Walnut, CA 91789-4560

Mailing address

18780 Amar Rd
Suite 107
Walnut, CA 91789-4560
Phone (626) 810-6777

Other names 1

  • Dr. Lei Chen Former name

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040806000679 CA Practitioner - Internal MedicinePractitioner - Emergency Medicine 7416929898 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18780 Amar Rd
Suite 107
Walnut, CA 91789-4558
Phone (626) 810-6777

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A78207CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Sierra Emergency Physicians Medical Group Inc Emergency Medicine CurrentSince Jan 1, 2011 Accepting new patients
Coast Plaza Doctors Hospital Past Accepting new patients
Prime Healthcare Services - Montclair, LLC Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1568445229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18780 AMAR RD",
            "address_2": "SUITE 107",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917894560",
            "telephone_number": "626-810-6777",
            "fax_number": "626-810-6687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18780 AMAR RD",
            "address_2": "SUITE 107",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917894560",
            "telephone_number": "626-810-6777",
            "fax_number": "626-810-6687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-26",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A78207",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A78207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEI",
            "last_name": "CHEN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Walnut, CA

Sources for this page

Verify at the official NPI Registry.