Individual provider Active NPI

Kelly Chin, M.D.

  • Gastroenterology Physician
  • Brooklyn, NY
National Provider Identifier
1922028067
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
195950 Issued in NY
Practice address
829 57TH St
2ND Floor
Brooklyn, NY 11220-3617
Phone
(718) 871-2511
Fax
(718) 871-0062
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 195950 NY
Gastroenterology Physician 207RG0100X 195950 NY Primary

Addresses

Primary practice location

829 57TH St
2ND Floor
Brooklyn, NY 11220-3617

Mailing address

93 Brown Cir
Paramus, NJ 07652-5203
Phone (718) 871-2511

Other identifiers 1

IdentifierTypeStateIssuer
01774758MedicaidNY

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
I20040406001404 NY Practitioner - Gastroenterology 5294728192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
State University of New York Downstate Medical Center, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

150 55TH St
Brooklyn, NY 11220-2508
Phone (718) 630-7000

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy280
Upper gastrointestinal (GI) endoscopy for acid reflux173

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University Gastroenterology CurrentSince Jul 1, 2024 Accepting new patients
New York University CurrentSince Jul 1, 2024 Accepting new patients

Locations

829 57th St
Fl 2
Brooklyn, NY 11220
Phone (718) 871-2511

355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

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

Interoperability endpoints

  • Direct secure messaging: kchin130484@nyumc.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1922028067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 BROWN CIR",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076525203",
            "telephone_number": "718-871-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 57TH ST",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203617",
            "telephone_number": "718-871-2511",
            "fax_number": "718-871-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "195950",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "195950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01774758",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.