Individual provider Active NPI

Norman Jermane Chan, M.D.

  • Otolaryngology/Facial Plastic Surgery Physician
  • New York, NY
National Provider Identifier
1003103615
Registry record updated Jan 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
282881 Issued in NY
Practice address
202 Canal St
Ste 602
New York, NY 10013-4517
Phone
(917) 261-2718
Fax
(917) 261-2719
NPI assigned
Jul 3, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MT199956 PA
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 282881 NY Primary

Addresses

Primary practice location

202 Canal St
Ste 602
New York, NY 10013-4517

Mailing address

202 Canal St
Ste 602
New York, NY 10013-4517
Phone (917) 261-2718

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170206001107 NY Practitioner - Otolaryngology 9931482544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

202 Canal St
Suite 602
New York, NY 10013-4517
Phone (917) 261-2718

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT199956PAMDOtolaryngology Physician
282881NYMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Manhattan Canal Medical, P.C. Otolaryngology/Facial Plastic Surgery CurrentSince Jan 15, 2018 Accepting new patients

Locations

202 Canal St
Ste 602
New York, NY 10013
Phone (917) 261-2718

Networks

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1309651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515974400000",
    "number": "1003103615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 CANAL ST",
            "address_2": "STE 602",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134517",
            "telephone_number": "917-261-2718",
            "fax_number": "917-261-2719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 CANAL ST",
            "address_2": "STE 602",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134517",
            "telephone_number": "917-261-2718",
            "fax_number": "917-261-2719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "NORMAN",
        "middle_name": "JERMANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-03",
        "last_updated": "2018-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MT199956",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "NY",
            "license": "282881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.