Individual provider Active NPI

Emmie Andrea Chen, M.D.

  • Emergency Medicine Physician
  • Kenosha, WI
National Provider Identifier
1699764068
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
48070-020 Issued in WI
Practice address
10400 75TH St
Kenosha, WI 53142-8323
Phone
(262) 948-5640
NPI assigned
Oct 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 48070-020 WI Primary

Addresses

Primary practice location

10400 75TH St
Kenosha, WI 53142-8323

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

3805B Spring St
Suite 230
Racine, WI 53405-1641
Phone (262) 687-4479

Other identifiers 1

IdentifierTypeStateIssuer
34671200MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address echen46960@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 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
I20050909000474 WI Practitioner - Emergency Medicine 4981636073 Reassigns benefits to 1 organization
I20130418000556 IL Practitioner - Emergency Medicine 4981636073 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

10400 75TH St
Kenosha, WI 53142-7884
Phone (262) 948-7000

Hospital & facility affiliations

  • Aurora Medical Center Kenosha Hospital, Kenosha, WI, CCN 520189

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48070-020WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Apr 1, 2013 Accepting new patients
Tri-County Emergency Physicians, LTD Emergency Medicine CurrentSince Mar 15, 2013 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Apr 1, 2013 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Apr 6, 2015 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Apr 6, 2015 Accepting new patients
Racine Emergency Physicians, S.C. Emergency Medicine Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

1475 E Belvidere Rd
Grayslake, IL 60030
Phone (847) 535-8800

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

800 N Westmoreland Rd
Ste 102
Lake Forest, IL 60045
Phone (847) 295-1300

660 N Westmoreland Rd
Lake Forest, IL 60045
Phone (847) 535-6100

450 W State Route 22
South Barrington, IL 60010
Phone (847) 381-0123

10400 75th St
Kenosha, WI 53142
Phone (262) 697-7000

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

3801 Spring St
Mount Pleasant, WI 53405
Phone (262) 636-4011

Interoperability endpoints

  • Direct secure messaging: echen46960@direct.myadvocateaurora.org

Organizations & group practices 6

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": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1699764068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 75TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531428323",
            "telephone_number": "262-948-5640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3805B Spring St",
            "address_2": "Suite 230",
            "address_purpose": "LOCATION",
            "city": "Racine",
            "state": "WI",
            "postal_code": "534051641",
            "country_code": "US",
            "telephone_number": "262-687-4479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "EMMIE",
        "middle_name": "ANDREA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-19",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "48070-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34671200",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "echen46960@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3805B Spring St",
            "address_2": "Suite 230",
            "city": "Racine",
            "state": "WI",
            "country_code": "US",
            "postal_code": "534051641",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3805B Spring St",
            "address_2": "Suite 230",
            "city": "Racine",
            "state": "WI",
            "country_code": "US",
            "postal_code": "534051641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.