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ROGER CHEN M.D.
NPI 1164786091
Urology in Newnan, GA

Active since June 26, 2012PECOS EnrolledAccepts Medicare Assignment
98.5/100
CMS Quality Rating
775 POPLAR RD STE 160, NEWNAN, GA 30265(770) 715-5192(706) 721-2548 Get Directions Write a Review

NPPES record last updated: December 1, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 1, 2025, Aug 7, 2017 (2 updates tracked since 2017).

About Roger Chen M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROGER CHEN M.D. (NPI 1164786091) is an individual urology provider in Newnan, Georgia, licensed in Georgia (005629) and active in the NPI registry since June 2012. He is enrolled in Medicare PECOS, is affiliated with Piedmont Newnan Hospital, Inc, and is a graduate of Wayne State University School Of Medicine (2012).

NPPES Registry Identity

NPI1164786091
Entity TypeIndividualMale
Primary Taxonomy208800000X
Provider Legal NameROGER CHENCredential: M.D.
Location Address775 POPLAR RD STE 160Newnan, GA 30265-8302
Mailing Address1120 15th StAugusta, GA 30912-0004
Phone(770) 715-5192
Fax(706) 721-2548
Sole ProprietorNo
Medical School CMSWayne State University School Of MedicineGraduated 2012
Enumeration DateJune 26, 2012
Last NPPES UpdateDecember 1, 20252 updates tracked since enumeration
NPPES CertifiedDecember 1, 2025
✔ NPI 1164786091 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Licenses✔ Licensed in GA · 005629✔ Licensed in SC · 95847
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
775 POPLAR RD STE 160, Newnan, GA 30265
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Roger Chen M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8224276902
PECOS Enrollment IDI20260108001972
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
628 services402 patients
Ultrasound measurement of bladder capacity after voiding 51798
Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.
486 services343 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
475 services311 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
135 services121 patients
Diagnostic exam of bladder and urethra using an endoscope 52000
This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.
86 services71 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
82 services82 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Piedmont Newnan Hospital, Inc

Acute Care Hospitals · Newnan, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110229
Location745 Poplar RoadNewnan, GA 30265 · Coweta County
Emergency services Birthing friendly

Prisma Health Richland Hospital

Acute Care Hospitals · Columbia, SC
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number420018
Location5 Medical ParkColumbia, SC 29203 · Richland County
Emergency services Birthing friendly

Prisma Health Baptist

Acute Care Hospitals · Columbia, SC
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number420086
Location1330 Taylor At Marion StColumbia, SC 29220 · Richland County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30265 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$66.89 typical visit price
range $16.68 – $133.24
Typical copayment $16.72 (range $4.17 – $33.31)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

98.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability98
Improvement Activities40

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
18%178 patients1/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
54%119 patients3/55-star benchmark: 100%
Medication Reconciliation Post-Discharge
The percentage of discharges from any inpatient facility (e.g. hospital, skilled nursing facility, or rehabilitation facility) for patients 18 years and older of age seen within 30 days following discharge in the office by the physician, prescribing…
Patients 65+: 96% · 27 patients
96%28 patients
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
63%178 patients3/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
78%204 patients4/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
2%173 patients1/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
61%49 patients3/55-star benchmark: 98%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351
DME-Orthotic Devices · category DF008N
4 suppliers13 claims2,490 services$1.75 avg. paid by Medicare
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each A4352
DME-Orthotic Devices · category DF008N
3 suppliers17 claims4,200 services$5.99 avg. paid by Medicare
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357
DME-Orthotic Devices · category DF000N
1 supplier12 claims24 services$7.31 avg. paid by Medicare
Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each A4373
DME-Orthotic Devices · category DF010N
1 supplier12 claims120 services$5.54 avg. paid by Medicare
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each A4432
DME-Orthotic Devices · category DF010N
1 supplier12 claims120 services$3.18 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARLY THAMER DONNET
Nurse Practitioner
775 POPLAR RD STE 160
NEWNAN, GA 30265
Coweta County (770) 400-4630
MR. NATHAN GARRETT DUFFEY AGACNP-BC
Nurse Practitioner
775 POPLAR RD STE 160
NEWNAN, GA 30265
Coweta County (770) 400-4630

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Roger Chen's NPI number?

The NPI number for Roger Chen is 1164786091. It was assigned to this individual provider in the NPPES registry on June 26, 2012.

Where is Roger Chen located?

Roger Chen practices at 775 Poplar Rd Ste 160, Newnan, GA 30265. The listed phone number is (770) 715-5192.

What is Roger Chen's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Roger Chen enrolled in Medicare?

Yes. Roger Chen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Roger Chen accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Roger Chen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Roger Chen affiliated with any hospitals?

According to CMS data, Roger Chen is affiliated with Piedmont Newnan Hospital, Inc, Prisma Health Richland Hospital and Prisma Health Baptist.

When was this NPI record last updated?

The NPPES record for Roger Chen was last updated on December 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.