Individual provider Active NPI

Jim Yijiang Chen, MD

  • Diagnostic Radiology Physician
  • Lebanon, NH
National Provider Identifier
1568705358
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
20141 Issued in NH
Practice address
One Medical Center Dr
Lebanon, NH 03756-0001
Phone
(603) 650-7650
NPI assigned
Apr 1, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 265367 MA
Diagnostic Radiology Physician 2085R0202X 20141 NH Primary

Addresses

Primary practice location

One Medical Center Dr
Lebanon, NH 03756-0001

Mailing address

One Medical Center Dr
Lebanon, NH 03756-0001
Phone (603) 650-7650

Other practice location 1

110 Liberty St
Brockton, MA 02301-5674
Phone (508) 565-3275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 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
I20180605002455 MA Practitioner - Diagnostic Radiology 8921225673 Reassigns benefits to 2 organizations
I20200326002329 NH Practitioner - Diagnostic Radiology 8921225673 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Signature Healthcare Medical Group IncGroup PAC ID 7719876267, 250 clinicians
Nashua Radiology PAGroup PAC ID 1052356169, 10 clinicians

Practice addresses (Care Compare)

110 Liberty St
Brockton, MA 02301-5521
Phone (508) 894-0400

172 Kinsley St
Nashua, NH 03060-3648
Phone (207) 784-2554

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20141NHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dartmouth-Hitchcock Clinic Diagnostic Radiology CurrentSince Mar 1, 2020 Accepting new patients
Harbor Medical Associates, Inc. CurrentSince Jul 30, 2019 Accepting new patients
Brigham & Womens Physicians Organization Inc CurrentSince Jul 1, 2018 Accepting new patients
Nashua Radiology PA Diagnostic Radiology CurrentSince Jul 1, 2022 Accepting new patients
Signature Healthcare Medical Group Inc CurrentSince Jun 1, 2024 Accepting new patients

Locations

75 Francis St
Boston, MA 02115

110 Liberty St
Brockton, MA 02301

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

172 Kinsley St
Nashua, NH 03060
Phone (603) 595-3926

Interoperability endpoints

  • Direct secure messaging: jim.chen@direct.signature.masshiway.net
  • Direct secure messaging: jchen390748@direct.dartmouth-hitchcock.org

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1364774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1568705358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-650-7650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-650-7650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Liberty St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023015674",
            "country_code": "US",
            "telephone_number": "508-565-3275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "JIM",
        "middle_name": "YIJIANG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-01",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "265367",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NH",
            "license": "20141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.