Individual provider Active NPI

Jennifer Chin, OD

  • Optometrist
  • Kew Gardens, NY
National Provider Identifier
1649791799
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
008584 Issued in NY
Practice address
8002 Kew Gardens Rd Ste C108
Kew Gardens, NY 11415-3609
Phone
(718) 544-2222
NPI assigned
Jun 29, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 008584 NY Primary

Addresses

Primary practice location

8002 Kew Gardens Rd Ste C108
Kew Gardens, NY 11415-3609

Mailing address

8002 Kew Gardens Rd Ste C108
Kew Gardens, NY 11415-3609
Phone (718) 544-2222

Other identifiers 1

IdentifierTypeStateIssuer
06757226MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20180319002154 NY Practitioner - Optometry 6406118082 Reassigns benefits to 2 organizations
Practice locations: Kew Gardens, NY

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8002 Kew Gardens Rd
Suite C108
Kew Gardens, NY 11415-3609
Phone (718) 544-2222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer Chin OD PLLC Optometrist CurrentSince Jan 1, 2023 Accepting new patients
Rye Eye Care OD PLLC Optometrist CurrentSince Jan 4, 2021 Accepting new patients

Locations

8002 Kew Gardens Rd
Ste C108
Kew Gardens, NY 11415
Phone (718) 544-2222

59 Purchase St
Rye, NY 10580
Phone (914) 967-2020

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": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1649791799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8002 KEW GARDENS RD STE C108",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114153609",
            "telephone_number": "718-544-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8002 KEW GARDENS RD STE C108",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114153609",
            "telephone_number": "718-544-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-29",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06757226",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kew Gardens, NY

Sources for this page

Verify at the official NPI Registry.