Jack P Chen, MD

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

040031 Issued in GA

Practice address

5670 Peachtree Dunwoody Rd Ste 880
Atlanta, GA 30342-4789

Phone

(404) 256-2525

Fax

(404) 256-9589

NPI assigned

Sep 9, 2005

Last updated

Oct 28, 2020By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)

Education

JS Weill Medical College, Cornell University, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northside Cardiovascular Professional Services, LLCGroup PAC ID 9739189838, 143 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Hospital, Atlanta, GA, CCN 110161
• Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
• Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
• Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087

Merit-based Incentive Payment System (MIPS)

Final score

77.82 of 100Reported as group

Quality

67.82

Promoting interoperability

77

Improvement activities

40

Cost

77.43

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

• Northside Cardiovascular Professional Services, LLC

  • Cardiovascular Disease Physician
  • Roswell, GA
  • NPI 1518979921
  Medicare reassignment Care Compare group NPD
• North Atlanta Professional Services LLC

  • Psychologist
  • Atlanta, GA
  • NPI 1316959869
  Medicare reassignment NPD
• Saint Josephs Hospital of Atlanta Inc

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1679664395
  Medicare reassignment NPD
• Northside Cardiology, PC

  • Specialist
  • Atlanta, GA
  • NPI 1619985074
  NPD
• Saint Josephs Hospital of Atlanta Inc

  dba St Josephs Apothecary

  • Community/Retail Pharmacy
  • Atlanta, GA
  • NPI 1497724181
  NPD

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

• Northside Hospital, Inc.

  dba Northside Hospital Cherokee

  • General Acute Care Hospital
  • Canton, GA
  • NPI 1225050396
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital Forsyth

  • General Acute Care Hospital
  • Cumming, GA
  • NPI 1376574277
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital Gwinnett

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Care Compare affiliation

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1821082389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5670 PEACHTREE DUNWOODY RD",
            "address_2": "STE 880",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424789",
            "telephone_number": "404-256-2525",
            "fax_number": "404-256-9589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5670 PEACHTREE DUNWOODY RD STE 880",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424789",
            "telephone_number": "404-256-2525",
            "fax_number": "404-256-9589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "JACK",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "040031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000659788B",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "NorthsideHeart@Northside.gwaydirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "5670 Peachtree Dunwoody Rd Ste 880",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303424789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bessie B Chen, MD
• Daniel Guagliardi Chen, MD, MPH&TM
• Danielle Chen, LMFT, RPT, ATR
• Edward P Chen, M.D.
• Emily Liu Chen
• Jincheng Chen
• Jonathan Chen, OD
• Justin Kai-Pan Chen, PHARMD
• Li-Kuang Chen
• Lucas Chen, MD

• Interventional Cardiology Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Interventional Cardiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.