Individual provider Active NPI

Jennifer Chin, MD

  • Internal Medicine Physician
  • Lanham, MD
National Provider Identifier
1902837461
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0092415 Issued in MD
Practice address
8116 Good Luck Rd Ste 300
Lanham, MD 20706-3508
Phone
(240) 241-7474
NPI assigned
Jul 5, 2006
Last updated
Jun 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD422688 PA
Internal Medicine Physician 207R00000X A87223 CA
Internal Medicine Physician 207R00000X MD2007-0167 NM
Internal Medicine Physician 207R00000X D0092415 MD Primary

Addresses

Primary practice location

8116 Good Luck Rd Ste 300
Lanham, MD 20706-3508

Mailing address

2000 Medical Pkwy Ste 409
Annapolis, MD 21401-3746
Phone (443) 481-5144

Other practice location 1

4815 Alameda Ave
El Paso, TX 79905-2705
Phone (915) 544-1200

Other identifiers 2

IdentifierTypeStateIssuer
64680541MedicaidNM
220773700MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230822002123 MD Practitioner - Internal Medicine 3870533607 Reassigns benefits to 1 organization
I20230822002334 DC Practitioner - Internal Medicine 3870533607 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0092415MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Sep 11, 2023 Accepting new patients
Luminis Health Medical Group, LLC Internal Medicine CurrentSince Sep 11, 2023 Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC Internal Medicine CurrentSince Sep 11, 2023 Accepting new patients
Providence Facey Medical Foundation Past Accepting new patients

Locations

2000 Medical Pkwy
Ste 409
Annapolis, MD 21401
Phone (443) 481-5136

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

4175 N Hanson Ct
Ste 201
Bowie, MD 20716
Phone (443) 481-1199

1630 Main St
Ste 213
Chester, MD 21619
Phone (443) 481-5300

8116 Good Luck Rd
Ste 300
Lanham, MD 20706
Phone (240) 241-7474

Interoperability endpoints

  • Direct secure messaging: jchin160311@direct.aahs.org

Organizations & group practices 6

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1902837461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 MEDICAL PKWY STE 409",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013746",
            "telephone_number": "443-481-5144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8116 GOOD LUCK RD STE 300",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063508",
            "telephone_number": "240-241-7474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4815 Alameda Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799052705",
            "country_code": "US",
            "telephone_number": "915-544-1200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHIN",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD422688",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A87223",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2007-0167",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0092415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64680541",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220773700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

Verify at the official NPI Registry.