Individual provider Active NPI

Michelle A. Chin, M.D.

  • Pediatrics Physician
  • Philadelphia, PA
National Provider Identifier
1659533214
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MT193746 Issued in PA
Practice address
3601 A St
Philadelphia, PA 19134-1043
Phone
(215) 427-5000
NPI assigned
Jun 25, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MT193746 PA Primary

Addresses

Primary practice location

3601 A St
Philadelphia, PA 19134-1043

Mailing address

106 Rennard Ter
Philadelphia, PA 19116-2606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 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
I20120103000401 OR Practitioner - Pediatric Medicine 1557537131 Reassigns benefits to 1 organization
I20120103000412 WA Practitioner - Pediatric Medicine 1557537131 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT193746PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Pediatrics Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest Pediatrics CurrentSince Oct 10, 2011 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Oct 10, 2011 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Pediatrics CurrentSince Oct 10, 2011 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

19185 SW 90th Ave
Tualatin, OR 97062
Phone (503) 723-6699

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1659533214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 RENNARD TER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 A ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341043",
            "telephone_number": "215-427-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN",
        "first_name": "MICHELLE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-25",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT193746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.