Jerome Hsi-Cheng Chin, M.D. PH.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

G65851 Issued in CA

Practice address

95 Montgomery Dr
Suite 102
Santa Rosa, CA 95404-6630

Phone

(707) 576-1461

Fax

(707) 576-0648

NPI assigned

Mar 10, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: jchin673911@nychhc.direct-ci.com

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.

• Spectrum O & P of Santa Rosa

  • Prosthetic/Orthotic Supplier
  • Santa Rosa, CA
  • NPI 1851760086
  NPD (past)

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

{
    "created_epoch": "1173484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992837496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 MONTGOMERY DR",
            "address_2": "SUITE 102",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954046630",
            "telephone_number": "707-576-1461",
            "fax_number": "707-576-0648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 MONTGOMERY DR",
            "address_2": "SUITE 102",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954046630",
            "telephone_number": "707-576-1461",
            "fax_number": "707-576-0648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN",
        "first_name": "JEROME",
        "middle_name": "HSI-CHENG",
        "name_prefix": "Dr.",
        "credential": "M.D. PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G65851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G658511",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Ann Chigazola, RDHAP, MS
• Chilcott MD Inc
• Forrest Scott Chilcott Jr., MD
• Marisha E. Chilcott, M.D.
• Ullrike Johanna Childs
• Warren Bruce Chin, MD
• Regina L. Chinn, LCSW
• Chiropractic Neurology Enhancement Center
• Michell L Chisham
• Nicholas Chiu, DDS

• Neurology Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.