Active NPI
Stephanie Chen
- Gerontology Nurse Practitioner
- New York, NY
National Provider Identifier
1891862009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 340423-1
- Practice address
- 1 Penn PLZ FL 8
Optumcare
New York, NY 10119-0899 - Phone
- (732) 718-0654
- Fax
- (187) 769-6846
- NPI assigned
- Nov 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 340423-1 | NY | Primary |
Addresses
Primary practice location
1 Penn PLZ FL 8
Optumcare
New York, NY 10119-0899
Mailing address
1 Penn PLZ FL 8
Optumcare
New York, NY 10119-0899
Phone (732) 718-0654
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020736641 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 340423-1 | NY | MD | Gerontology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444176000000",
"number": "1891862009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 PENN PLZ FL 8",
"address_2": "OPTUMCARE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101190899",
"telephone_number": "732-718-0654",
"fax_number": "187-769-6846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PENN PLZ FL 8",
"address_2": "OPTUMCARE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101190899",
"telephone_number": "732-718-0654",
"fax_number": "187-769-6846"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEN",
"first_name": "STEPHANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-30",
"last_updated": "2015-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "NY",
"license": "340423-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "020736641",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.