Individual provider Active NPI

Kenneth C Chern, M.D.

  • Ophthalmology Physician
  • Burlingame, CA
National Provider Identifier
1790880078
Registry record updated Jun 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G82279 Issued in CA
Practice address
1720 El Camino Real Ste 225
Burlingame, CA 94010-3230
Phone
(650) 697-3200
Fax
(650) 697-3203
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G82279 CA Primary

Addresses

Primary practice location

1720 El Camino Real Ste 225
Burlingame, CA 94010-3230

Mailing address

1720 El Camino Real Ste 225
Burlingame, CA 94010-3230
Phone (650) 697-3200

Other identifiers 1

IdentifierTypeStateIssuer
00G822790MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20051101001225 CA Practitioner - OphthalmologyPractitioner - Internal Medicine 9931126554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Northwestern University Feinberg Medical School, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peninsula Ophthalmology Group IncGroup PAC ID 0042281164, 8 clinicians

Practice addresses (Care Compare)

1720 El Camino Real
Suite 225
Burlingame, CA 94010-3230
Phone (650) 697-3200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery140

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G82279CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Ophthalmology Group, Inc. Ophthalmology CurrentSince Jan 3, 2007 Accepting new patients

Locations

1720 El Camino Real
Ste 225
Burlingame, CA 94010
Phone (650) 552-8070

901 Campus Dr
Ste 205
Daly City, CA 94015
Phone (650) 343-9746

291 Geary St
Ste 700
San Francisco, CA 94102
Phone (415) 326-3364

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kchern45892@hisp.ehr.sutterhealth.org

Organizations & group practices 1

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 2

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1790880078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 EL CAMINO REAL STE 225",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103230",
            "telephone_number": "650-697-3200",
            "fax_number": "650-697-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 EL CAMINO REAL STE 225",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103230",
            "telephone_number": "650-697-3200",
            "fax_number": "650-697-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERN",
        "first_name": "KENNETH",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G82279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G822790",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, CA

Sources for this page

Verify at the official NPI Registry.