Jeremy Wong Chin, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

A159035 Issued in CA

Practice address

18436 Roscoe Blvd
Northridge, CA 91325-4107

Phone

(818) 435-1400

NPI assigned

Apr 8, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, HI2 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

Specialty

Diagnostic Radiology

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Renaissance Imaging Medical Associates IncGroup PAC ID 7315841756, 126 clinicians

Golden State Imaging Associates IncGroup PAC ID 1254761315, 242 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Saint Joseph Medical Ctr Hospital, Burbank, CA, CCN 050235
• Glendale Mem Hospital & HLTH Center Hospital, Glendale, CA, CCN 050058
• Northridge Hospital Medical Center Hospital, Northridge, CA, CCN 050116
• Antelope Valley Hospital Hospital, Lancaster, CA, CCN 050056
• Valley Presbyterian Hospital Hospital, Van Nuys, CA, CCN 050126
• Providence St Joseph Med Ctr Inpatient rehabilitation facility, Burbank, CA, CCN 05T235

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Renaissance Imaging Medical Associates, Inc.

  • Diagnostic Radiology Physician
  • Northridge, CA
  • NPI 1487608931

  HI

  Medicare reassignment Care Compare group NPD
• Golden State Imaging Associates Inc

  • Diagnostic Radiology Physician
  • Houston, TX
  • NPI 1144872052

  CA

  Medicare reassignment Care Compare group NPD
• Antelope Valley Outpatient Imaging Center, LLC

  • Diagnostic Radiology Physician
  • Lancaster, CA
  • NPI 1376143339
  NPD
• Rad Alliance, Inc.

  • Specialist
  • Los Angeles, CA
  • NPI 1184810277
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Antelope Valley Health Care District

  • General Acute Care Hospital
  • Lancaster, CA
  • NPI 1366419517
  Care Compare affiliation
• Dignity Community Care

  • General Acute Care Hospital
  • Northridge, CA
  • NPI 1417089350
  Care Compare affiliation
• Dignity Community Care

  • General Acute Care Hospital
  • Glendale, CA
  • NPI 1477610640
  Care Compare affiliation
• Providence Health System - Southern California

  • General Acute Care Hospital
  • Burbank, CA
  • NPI 1336173269
  Care Compare affiliation
• Providence Health System - Southern California

  • Rehabilitation Hospital Unit
  • Burbank, CA
  • NPI 1669490819

  Inpatient rehabilitation facility

  Care Compare affiliation
• Valley Presbyterian Hospital

  • General Acute Care Hospital
  • Van Nuys, CA
  • NPI 1578529285
  Care Compare affiliation

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

{
    "created_epoch": "1365379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1700229994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 GUARDIAN ST STE 205",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930636721",
            "telephone_number": "855-504-4544",
            "fax_number": "805-577-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18436 ROSCOE BLVD",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254107",
            "telephone_number": "818-435-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Baystate Medical Ctr",
            "address_2": "759 Chestnut Street",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011991001",
            "country_code": "US",
            "telephone_number": "413-794-0000",
            "fax_number": "413-794-5940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHIN",
        "first_name": "JEREMY",
        "middle_name": "WONG",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-08",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A159035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Child and Family Guidance Center
• Child and Family Guidance Center
• Child and Family Guidance Center
• Child and Family Guidance Center
• Faith Lee Chin
• Margie Uzoma Chinasa, M.D
• Shannon Matthew Chiongbian, PT, DPT
• Ekaterine K Chiradze, P. A .
• Chase C Cho, DO
• Matthew Cho

• Diagnostic Radiology Physician in Northridge, CA
• Providers in Northridge, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.