Individual provider Active NPI

Glendy Chen

  • Family Nurse Practitioner
  • Riverside, CA
National Provider Identifier
1619388741
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95000058 Issued in CA
Practice address
7117 Brockton Ave
Riverside Medical Clinic-Adult Medicine
Riverside, CA 92506-2658
Phone
(951) 782-3724
NPI assigned
May 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95000058 CA Primary

Addresses

Primary practice location

7117 Brockton Ave
Riverside Medical Clinic-Adult Medicine
Riverside, CA 92506-2658

Mailing address

7117 Brockton Ave.
Riverside Medical Clinic-Adult Medicine
Riverside, CA 92506

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140725001191 CA Practitioner - Nurse Practitioner 9931325024 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11370 Anderson St
Loma Linda, CA 92354-3450

25455 Barton Rd
Suite 108a
Loma Linda, CA 92354-3139
Phone (909) 558-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jul 11, 2017 Accepting new patients
Riverside Medical Clinic, Inc CurrentSince May 3, 2014 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jul 11, 2017 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Riverside Medical Clinic, Inc Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients

Locations

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

24785 Stewart St
Ste 111
Loma Linda, CA 92350
Phone (909) 558-4594

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

3660 Arlington Ave
Riverside, CA 92506
Phone (951) 782-3789

Interoperability endpoints

  • Direct secure messaging: gchen89920@direct.llu.edu

Organizations & group practices 7

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 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": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399852800000",
    "number": "1619388741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7117 BROCKTON AVE.",
            "address_2": "RIVERSIDE MEDICAL CLINIC-ADULT MEDICINE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7117 BROCKTON AVE",
            "address_2": "RIVERSIDE MEDICAL CLINIC-ADULT MEDICINE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062658",
            "telephone_number": "951-782-3724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "GLENDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-12",
        "last_updated": "2014-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95000058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.