Organization Active NPI

Dr. Bojun Chen'S Medical Rehab, P.C.

  • Physical Medicine & Rehabilitation Physician
  • Flushing, NY
National Provider Identifier
1801080189
Registry record updated Nov 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
220919 Issued in NY
Legal business name
DR. BOJUN CHEN'S MEDICAL REHAB, P.C.
Practice address
13237 41St Rd
Room 103
Flushing, NY 11355-4242
Phone
(718) 321-7290
Fax
(718) 321-7289
NPI assigned
Aug 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2007

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

Authorized official

Name
Bojun Chen, M.D.NPI 1477505667
Title
Ceo
Phone
(718) 321-7290

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 220919 NY Primary

Addresses

Primary practice location

13237 41St Rd
Room 103
Flushing, NY 11355-4242

Mailing address

17 Central CT
Carle Place, NY 11514-1199
Phone (718) 663-4826

Other identifiers 2

IdentifierTypeStateIssuer
04611BOtherNYGHI MEDICARE
02205769MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070919000297 NY Part B Supplier - Clinic/Group Practice 3971697160 Receives reassigned benefits from 1 practitioner
Practice locations: Flushing, NY

National Provider Directory

National Provider Directory

Locations

13237B 41st Rd
Ste 103
Flushing, NY 11355
Phone (718) 321-7290

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195603200000",
    "number": "1801080189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 CENTRAL CT",
            "city": "CARLE PLACE",
            "state": "NY",
            "postal_code": "115141199",
            "telephone_number": "718-663-4826",
            "fax_number": "718-321-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13237 41ST RD",
            "address_2": "ROOM 103",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113554242",
            "telephone_number": "718-321-7290",
            "fax_number": "718-321-7289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. BOJUN CHEN'S MEDICAL REHAB, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-30",
        "last_updated": "2007-11-21",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "BOJUN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-321-7290",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "220919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI MEDICARE",
            "identifier": "04611B",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02205769",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.