Individual provider Active NPI

David Li-Kang Chen, M.D.

  • MOHS-Micrographic Surgery Physician
  • Norwich, CT
National Provider Identifier
1922364611
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
67333 Issued in CT
Practice address
111 Salem Tpke Ste 7
Norwich, CT 06360-7403
Phone
(860) 859-2262
NPI assigned
Apr 6, 2012
Last updated
Apr 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 67333 CT Primary

Addresses

Primary practice location

111 Salem Tpke Ste 7
Norwich, CT 06360-7403

Mailing address

111 Salem Tpke Ste 7
Norwich, CT 06360-7403
Phone (860) 859-2262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20210409001385 CT Practitioner - Dermatology 0941524250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Northwestern University Feinberg Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology LLCGroup PAC ID 5092706945, 9 clinicians

Practice addresses (Care Compare)

111 Salem Tpke
Suite 7
Norwich, CT 06360-7403
Phone (860) 859-2262

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision64
Removal of skin lesions46
Removal of skin cancer650
Skin biopsy83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67333CTMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dermatology LLC Dermatology CurrentSince Dec 3, 2020 Accepting new patients

Locations

111 Salem Tpke
Ste 7
Norwich, CT 06360
Phone (860) 859-2262

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": "1333670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1922364611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 SALEM TPKE STE 7",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063607403",
            "telephone_number": "860-859-2262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SALEM TPKE STE 7",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063607403",
            "telephone_number": "860-859-2262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "DAVID",
        "middle_name": "LI-KANG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-06",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CT",
            "license": "67333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.