Individual provider Active NPI

Ling Chen, AGPCNP-BC

  • Gerontology Nurse Practitioner
  • Montclair, NJ
National Provider Identifier
1962903914
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
26NJ00820200 Issued in NJ
Practice address
28 Valley Rd Ste 1
Montclair, NJ 07042-2709
Phone
(201) 565-0979
NPI assigned
Feb 26, 2018
Last updated
May 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 308607 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ00820200 NJ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 405477 NY
Gerontology Nurse Practitioner 363LG0600X 26NJ00820200 NJ Primary

Addresses

Primary practice location

28 Valley Rd Ste 1
Montclair, NJ 07042-2709

Mailing address

206 Bergen Ave
Kearny, NJ 07032-3384
Phone (201) 991-9090

Other practice location 1

57 W 75th St Apt 1A
New York, NY 10023-2007
Phone (212) 764-4647

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180621002079 NJ Practitioner - Nurse Practitioner 9931454568 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

199 Passaic Ave
Roseland, NJ 07068-1105
Phone (201) 565-0979

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00820200NJMDPsychiatric/Mental Health Nurse Practitioner
405477NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Primary Care Services CurrentSince Oct 2, 2021 Accepting new patients
Innerwave Health LLC CurrentSince Dec 19, 2023 Accepting new patients

Locations

206 Bergen Ave
Kearny, NJ 07032
Phone (201) 955-2010

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

28 Valley Rd
Montclair, NJ 07042
Phone (908) 451-8519

25 Kilmer Dr
Ste 107
Morganville, NJ 07751
Phone (732) 385-5262

3 Executive Dr
Ste 400
Somerset, NJ 08873
Phone (732) 369-5949

8 Mountain Blvd
Ste J
Warren, NJ 07059
Phone (732) 893-0200

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, 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": "1519603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1962903914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 BERGEN AVE",
            "city": "KEARNY",
            "state": "NJ",
            "postal_code": "070323384",
            "telephone_number": "201-991-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 VALLEY RD STE 1",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422709",
            "telephone_number": "201-565-0979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "57 W 75th St Apt 1A",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100232007",
            "country_code": "US",
            "telephone_number": "212-764-4647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "LING",
        "name_prefix": "Mrs.",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-26",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "308607",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00820200",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "405477",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00820200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

Verify at the official NPI Registry.