Active NPI
Matthew Chen, M.D.
- General Practice Physician
- Portsmouth, VA
National Provider Identifier
1972044212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 236573
- Practice address
- 620 John Paul Jones Cir
Portsmouth, VA 23708-2111 - Phone
- (757) 953-2518
- NPI assigned
- Mar 20, 2017
- Last updated
- Jan 7, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| General Practice Physician | 208D00000X | 236573 | NC | Primary |
Addresses
Primary practice location
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Mailing address
3901 Main St Apt 5a
Buffalo, NY 14226-3352
Other practice location 1
100 Brewster Blvd
Camp Lejeune, NC 28547-2575
Phone (910) 451-5987
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170727002178 | VA | Order and Referring Only - General Surgery | 7113297813 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 236573 | NC | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641513600000",
"number": "1972044212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3901 MAIN ST APT 5A",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142263352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 JOHN PAUL JONES CIR",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237082111",
"telephone_number": "757-953-2518"
}
],
"practiceLocations": [
{
"address_1": "100 Brewster Blvd",
"address_purpose": "LOCATION",
"city": "Camp Lejeune",
"state": "NC",
"postal_code": "285472575",
"country_code": "US",
"telephone_number": "910-451-5987",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHEN",
"first_name": "MATTHEW",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-03-20",
"last_updated": "2022-01-07",
"certification_date": "2022-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NC",
"license": "236573",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portsmouth, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.