Individual provider Active NPI

Chun Wen Chen, M.D.

  • Diagnostic Radiology Physician
  • Miramar Beach, FL
National Provider Identifier
1669458246
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME104689 Issued in FL
Practice address
7800 US Highway 98 W
Miramar Beach, FL 32550-7228
Phone
(850) 278-3556
NPI assigned
Dec 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME104689 FL Primary

Addresses

Primary practice location

7800 US Highway 98 W
Miramar Beach, FL 32550-7228

Mailing address

7800 US Highway 98 W
Miramar Beach, FL 32550-7228
Phone (850) 797-2119

Other identifiers 6

IdentifierTypeStateIssuer
001359200MedicaidFL
150ZFOtherFLBCBS
CN077VOtherFLMEDICARE PTAN
CN077WOtherFLMEDICARE PTAN
CN077XOtherFLMEDICARE PTAN
P01667379OtherFLRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20091209000219 FL Practitioner - Diagnostic Radiology 5193864825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Tulane University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Destin Regional Imaging Center LLCGroup PAC ID 8921050782, 3 clinicians

Practice addresses (Care Compare)

7800 US Hwy 98 W
Miramar Beach, FL 32550-7228
Phone (850) 278-3556

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME104689FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Destin Regional Imaging Center LLC Diagnostic Radiology CurrentSince May 29, 2022 Accepting new patients
Destin Regional Imaging Center LLC Diagnostic Radiology CurrentSince Oct 9, 2017 Accepting new patients

Locations

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

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.

Hospital & facility affiliations 5

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": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1669458246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 US HIGHWAY 98 W",
            "city": "MIRAMAR BEACH",
            "state": "FL",
            "postal_code": "325507228",
            "telephone_number": "850-797-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 US HIGHWAY 98 W",
            "city": "MIRAMAR BEACH",
            "state": "FL",
            "postal_code": "325507228",
            "telephone_number": "850-278-3556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "CHUN",
        "middle_name": "WEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME104689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001359200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "150ZF",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CN077V",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CN077W",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CN077X",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01667379",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar Beach, FL

Sources for this page

Verify at the official NPI Registry.