Active NPI
Konhsin Connie Wang Chen, O.D.
- Optometrist
- Concord, CA
National Provider Identifier
1972598910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT 6578 TPA
- Practice address
- 2425 East St., Suite #4
Concord, CA 94520-1925 - Phone
- (925) 689-2852
- Fax
- (925) 689-1966
- NPI assigned
- Sep 15, 2005
- Reactivated
- Apr 11, 2006
- Last updated
- Dec 1, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT 6578 TPA | CA | Primary |
Addresses
Primary practice location
2425 East St., Suite #4
Concord, CA 94520-1925
Mailing address
2425 East St., Suite #4
Concord, CA 94520-1925
Phone (925) 689-2852
Other names 1
- Dr. K.Connie Wang
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110906000744 | CA | Practitioner - Optometry | 2860662582 | Practice locations: Concord, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT 6578 TPA | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Connie Wang-Chen | Optometrist | Past | Accepting new patients |
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": "1126742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480550400000",
"number": "1972598910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2425 EAST ST., SUITE #4",
"city": "CONCORD",
"state": "CA",
"postal_code": "945201925",
"telephone_number": "925-689-2852",
"fax_number": "925-689-1966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2425 EAST ST., SUITE #4",
"city": "CONCORD",
"state": "CA",
"postal_code": "945201925",
"telephone_number": "925-689-2852",
"fax_number": "925-689-1966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEN",
"first_name": "KONHSIN CONNIE",
"middle_name": "WANG",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-09-15",
"last_updated": "2016-12-01",
"deactivation_date": "2006-03-23",
"reactivation_date": "2006-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "OPT 6578 TPA",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "K.CONNIE",
"last_name": "WANG",
"prefix": "DR.",
"credential": "O.D.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Concord, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; 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.