Individual provider Active NPI

Pauline Laiyue Chen, DO

  • Ophthalmology Physician
  • Mankato, MN
National Provider Identifier
1871014837
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
68778 Issued in MN
Practice address
1421 Premier Dr
Mankato, MN 56001-6076
Phone
(507) 625-1811
NPI assigned
Jun 29, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 5151009255 MI
Ophthalmology Physician 207W00000X 68778 MN Primary

Addresses

Primary practice location

1421 Premier Dr
Mankato, MN 56001-6076

Mailing address

1421 Premier Dr
Mankato, MN 56001-6076
Phone (507) 625-1811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20210630000195 MN Practitioner - Ophthalmology 1658639356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mankato Clinic LTDGroup PAC ID 5597677955, 243 clinicians

Practice addresses (Care Compare)

1230 E Main St
Mankato, MN 56001-5066
Phone (507) 389-8509

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery109

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5151009255MIMDOphthalmology Physician
68778MNMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mankato Clinic LTD Ophthalmology CurrentSince Jul 1, 2021 Accepting new patients

Locations

1230 E Main St
Mankato, MN 56001
Phone (507) 389-8502

1421 Premier Dr
Mankato, MN 56001
Phone (507) 385-4000

Interoperability endpoints

  • Direct secure messaging: paulinechen@mklt.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1871014837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 PREMIER DR",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016076",
            "telephone_number": "507-625-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 PREMIER DR",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016076",
            "telephone_number": "507-625-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "PAULINE",
        "middle_name": "LAIYUE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-29",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "5151009255",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "68778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

Verify at the official NPI Registry.