Jackson Chen, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

69038 Issued in CT

Practice address

71 Haynes St
Manchester, CT 06040-4131

Phone

(860) 533-4679

NPI assigned

Mar 14, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Family Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Trinity Health of New England Provider Network Organization IncGroup PAC ID 0941113567, 644 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health of New England at Home Home health agency, Hartford, CT, CCN 077005
• Hartford Healthcare at Home Home health agency, East Hartford, CT, CCN 077041
• Johnson Memorial Hospital Hospital, Stafford Springs, CT, CCN 070008

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jchen2388616@direct.trinity-health.org

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.

• Trinity Health of New England Provider Network Organization Inc

  • Internal Medicine Physician
  • Hartford, CT
  • NPI 1003882812
  Medicare reassignment Care Compare group NPD
• Prospect CT Medical Foundation, Inc.

  • Family Medicine Physician
  • Manchester, CT
  • NPI 1144677568
  Medicare reassignment NPD
• Sound Physicians of Massachusetts II PC

  • Internal Medicine Physician
  • Brockton, MA
  • NPI 1306376397

  CT

  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Connecticut, LLC

  • Internal Medicine Physician
  • Manchester, CT
  • NPI 1558696153
  Medicare reassignment
• Trinity Health of New England Provider Network Organization Inc

  • Internal Medicine Physician
  • Waterville, ME
  • NPI 1134779531
  NPD

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

• Hartford Healthcare at Home, Inc

  • Home Health Agency
  • Wethersfield, CT
  • NPI 1073529566
  Care Compare affiliation
• Johnson Memorial Hospital, Inc.

  • Psychiatric Hospital Unit
  • Stafford Springs, CT
  • NPI 1053480293
  Care Compare affiliation
• Johnson Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Stafford Springs, CT
  • NPI 1932123569
  Care Compare affiliation
• Johnson Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Stafford Springs, CT
  • NPI 1972728442
  Care Compare affiliation
• Trinity Home Health Services

  • Home Health Agency
  • Hartford, CT
  • NPI 1992702757
  Care Compare affiliation

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625270400000",
    "number": "1710480892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 HAYNES ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404131",
            "telephone_number": "860-646-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 HAYNES ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404131",
            "telephone_number": "860-533-4679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Hartford Rd",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "CT",
            "postal_code": "060405921",
            "country_code": "US",
            "telephone_number": "860-533-4673",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "29 Haynes St",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "CT",
            "postal_code": "060404139",
            "country_code": "US",
            "telephone_number": "860-533-4678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "JACKSON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-14",
        "last_updated": "2021-07-03",
        "certification_date": "2021-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "69038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710480892",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan L Chasen, M.D.
• Tahir M Chaudhry
• Jai Chavis, MD
• Chella Chiropractic, LLC
• Matthew Chella, DC
• Paige Alana Chen, BCBA, LBA
• Maria A Cheney, MFT
• Sueyoung CHI, D.D.S
• Erin Chiaputti, LCSW
• Onyekatchi John Chidiadi

• Family Medicine Physician in Manchester, CT
• Providers in Manchester, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2021; 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.