MEDICARE: DR. KURT Y. CHEN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	0101050710	VA
2	207Y00000X	Otolaryngology Physician	0101050710	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	040006937	OTHER	VA	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	087653	OTHER	VA	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	299660	OTHER	VA	MAMSI
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	T61702	OTHER		JOHN DEERE

General Provider Information

NPI Number	:	1700880408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KURT Y. CHEN M.D.

Provider Business Mailing Address
First Line	:	213 S JEFFERSON ST STE 1006
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24011-1713
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	35 MEDICAL CT
Second Line	:
City	:	HARDY
State	:	VA
Zip	:	24101-3992
Country	:	US
Telephone Number	:	540-769-0700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	08/15/2025

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