Individual provider Active NPI

Bertram T Chinn, M.D.

  • Colon & Rectal Surgery Physician
  • Edison, NJ
National Provider Identifier
1811968944
Registry record updated Feb 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
25MA05818800 Issued in NJ
Practice address
3900 Park Ave
Suite 101
Edison, NJ 08820-3032
Phone
(732) 494-6640
Fax
(732) 549-8204
NPI assigned
Jan 27, 2006
Last updated
Feb 10, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 25MA05818800 NJ Primary

Addresses

Primary practice location

3900 Park Ave
Suite 101
Edison, NJ 08820-3032

Mailing address

PO Box 416457
Boston, MA 02241-6457

Other identifiers 1

IdentifierTypeStateIssuer
6065503MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20110523000259 NJ Practitioner - Colorectal Surgery (Proctology) 9234297532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Jefferson Medical College of Thomas Jefferson University, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596

11 Overlook Rd
Summit, NJ 07901-3577
Phone (908) 273-1493

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy175
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group CurrentSince Sep 18, 2013 Accepting new patients

Locations

3900 Park Ave
Ste 101
Edison, NJ 08820
Phone (732) 372-6640

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

2301 Park Ave
South Plainfield, NJ 07080
Phone (908) 756-4438

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455062400000",
    "number": "1811968944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 PARK AVE",
            "address_2": "SUITE 101",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203032",
            "telephone_number": "732-494-6640",
            "fax_number": "732-549-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHINN",
        "first_name": "BERTRAM",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2016-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NJ",
            "license": "25MA05818800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6065503",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

Verify at the official NPI Registry.