Individual provider Active NPI

Edward Chen, MD

  • Dermatology Physician
  • Marietta, GA
National Provider Identifier
1982133633
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD.37350 Issued in AL
Practice address
4800 Olde Towne Pkwy Ste 250
Marietta, GA 30068-4428
Phone
(770) 971-3376
NPI assigned
Jun 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125070892 IL
Dermatology Physician 207N00000X MD.37350 AL Primary

Addresses

Primary practice location

4800 Olde Towne Pkwy Ste 250
Marietta, GA 30068-4428

Mailing address

4800 Olde Towne Pkwy Ste 250
Marietta, GA 30068-4428
Phone (770) 971-3376

Other practice location 1

5841 S Maryland Ave
Chicago, IL 60637-1447
Phone (773) 795-0232

Other practice location 2

5841 S Maryland Ave Ste Mc7082
Chicago, IL 60637-1465
Phone (773) 795-0232

Other practice location 3

500 22nd St S Ste 3500
Birmingham, AL 35233
Phone (205) 996-7546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20210402000311 GA Practitioner - Dermatology 8426327149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Alabama School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology and Surgery Specialists of North Atlanta PCGroup PAC ID 3476964701, 3 clinicians

Practice addresses (Care Compare)

4800 Olde Towne Pkwy
Suite 250
Marietta, GA 30068-4428
Phone (770) 971-3376

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision32
Removal of skin lesions1223
Removal of nail tissue1-10
Skin biopsy293

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.37350ALMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology and Surgery Specialists of North Atlanta PC Dermatology CurrentSince Apr 1, 2021 Accepting new patients
Dermatology Consultants, P.C. Dermatology PastSince Apr 1, 2021 Accepting new patients

Locations

4800 Olde Towne Pkwy
Ste 250
Marietta, GA 30068
Phone (770) 971-3376

Interoperability endpoints

  • Direct secure messaging: echen@dessna.emadirect.md

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.

NPI Registry JSON

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1982133633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 OLDE TOWNE PKWY STE 250",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684428",
            "telephone_number": "770-971-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 OLDE TOWNE PKWY STE 250",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684428",
            "telephone_number": "770-971-3376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5841 S Maryland Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371447",
            "country_code": "US",
            "telephone_number": "773-795-0232",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5841 S Maryland Ave Ste Mc7082",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371465",
            "country_code": "US",
            "telephone_number": "773-795-0232",
            "fax_number": "773-702-2230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 22nd St S Ste 3500",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "35233",
            "country_code": "US",
            "telephone_number": "205-996-7546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-07",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125070892",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AL",
            "license": "MD.37350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.