Individual provider Active NPI

Renee Marie Chin, MD

  • Student in an Organized Health Care Education/Training Program
  • Hartford, CT
National Provider Identifier
1871876904
Registry record updated Sep 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
114 Woodland Park
Hartford, CT 06105-1219
Phone
(860) 714-5170
NPI assigned
Sep 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CT Primary

Addresses

Primary practice location

114 Woodland Park
Hartford, CT 06105-1219

Mailing address

114 Woodland Park
Hartford, CT 06105-1219
Phone (860) 714-5170

Other identifiers 1

IdentifierTypeStateIssuer
06-0646813OtherCTST. FRANCIS HOSPITAL MEDICAL CENTER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20150827002623 NY Practitioner - Obstetrics/Gynecology 0547576183 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jun 10, 2019 Accepting new patients
Bethpage Medical, PLLC CurrentSince Aug 1, 2015 Accepting new patients
Ocean Perinatology PLLC CurrentSince Aug 1, 2015 Accepting new patients
Long Island Jewish Medical Center Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

16303 Horace Harding Expy
Ste 300
Fresh Meadows, NY 11365
Phone (718) 464-3000

200 Garden City Plz
Ste 100
Garden City, NY 11530
Phone (516) 414-6900

600 Northern Blvd
Ste 106
Great Neck, NY 11021
Phone (516) 466-4128

27005 76th Ave
#454
New Hyde Park, NY 11040

220 E 63rd St
Lbby J
New York, NY 10065
Phone (212) 308-3088

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1316995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410393600000",
    "number": "1871876904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 WOODLAND PARK",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051219",
            "telephone_number": "860-714-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 WOODLAND PARK",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051219",
            "telephone_number": "860-714-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN",
        "first_name": "RENEE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-26",
        "last_updated": "2014-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ST. FRANCIS HOSPITAL MEDICAL CENTER",
            "identifier": "06-0646813",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.