Individual provider Active NPI

Tina Chen, MD

  • Ophthalmology Physician
  • Fort Worth, TX
National Provider Identifier
1679991053
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
R9737 Issued in TX
Practice address
1201 Summit Ave
Fort Worth, TX 76102-4413
Phone
(817) 332-2020
Fax
(817) 332-4797
NPI assigned
Apr 2, 2014
Last updated
Nov 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Ophthalmology Physician 207W00000X 036.145557 IL
Ophthalmology Physician 207W00000X 125065018 IL
Ophthalmology Physician 207W00000X R9737 TX Primary

Addresses

Primary practice location

1201 Summit Ave
Fort Worth, TX 76102-4413

Mailing address

680 N Lake Shore Dr
Chicago, IL 60611-4546
Phone (312) 695-6868

Other practice location 1

809 W Harwood Rd Ste 304
Hurst, TX 76054-6246
Phone (817) 788-9303

Other identifiers 1

IdentifierTypeStateIssuer
401702201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190717002017 TX Practitioner - Ophthalmology 7113220039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Cincinnati College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ophthalmic Partners , PAGroup PAC ID 4587578364, 14 clinicians

Practice addresses (Care Compare)

1201 Summit Ave
Fort Worth, TX 76102-4413
Phone (817) 332-2020

Merit-based Incentive Payment System (MIPS)

Final score
92.66 of 100Reported as group
Quality
99.97
Improvement activities
40
Cost
75.57

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery91

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.145557ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ophthalmic Partners , PA Ophthalmology Current Accepting new patients
Ophthalmic Partners, PA Ophthalmology CurrentSince Aug 10, 2019 Accepting new patients

Locations

5801 Oakbend Trl
Ste 100
Fort Worth, TX 76132
Phone (817) 346-2969

1201 Summit Ave
Ft Worth, TX 76102
Phone (817) 332-2020

809 W Harwood Rd
Ste 304
Hurst, TX 76054
Phone (817) 788-9303

804 Santa Fe Dr
Weatherford, TX 76086
Phone (817) 341-5609

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1679991053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "312-695-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 SUMMIT AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761024413",
            "telephone_number": "817-332-2020",
            "fax_number": "817-332-4797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "809 W Harwood Rd Ste 304",
            "address_purpose": "LOCATION",
            "city": "Hurst",
            "state": "TX",
            "postal_code": "760546246",
            "country_code": "US",
            "telephone_number": "817-788-9303",
            "fax_number": "817-332-4797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "TINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-02",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036.145557",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "125065018",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "R9737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401702201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.