Wallen Cy Chan, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

183203 Issued in NY

Practice address

78 Todt Hill Rd
Staten Island, NY 10314-4528

Phone

(718) 448-1122

Fax

(718) 448-8318

NPI assigned

Mar 1, 2006

Sex

Male

Sole proprietor

No

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

Specialty

GastroenterologyAlso: Internal Medicine

Education

Icahn School of Medicine at Mount Sinai, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Amboy Medical Practice PCGroup PAC ID 2860538170, 171 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Richmond University Medical Center Hospital, Staten Island, NY, CCN 330028
• Staten Island University Hospital Hospital, Staten Island, NY, CCN 330160

Merit-based Incentive Payment System (MIPS)

Final score

71.48 of 100Reported as apm

Quality

82.91

Promoting interoperability

5.67

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: wallen.chan.1@19656.direct.athenahealth.com
• Direct secure messaging: wallenchan@mai.allscriptsdirect.net

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.

• Amboy Medical Practice PC

  • Internal Medicine Physician
  • Staten Island, NY
  • NPI 1700037975
  Medicare reassignment Care Compare group NPD
• Todt Hill Endoscopy, P.C.

  • Anesthesiology Physician
  • Staten Island, NY
  • NPI 1538441902
  NPD (past) Authorized official
• Amboy Medical Practice PC

  • Diagnostic Radiology Physician
  • Staten Island, NY
  • NPI 1104692672
  NPD
• Maimonides Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1093777492
  NPD
• Richmond University Medical Center

  • Multi-Specialty Clinic/Center
  • Staten Island, NY
  • NPI 1811054042
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Richmond Medical Center

  • General Acute Care Hospital
  • Staten Island, NY
  • NPI 1740389154
  Care Compare affiliation
• Staten Island University Hospital

  • General Acute Care Hospital
  • Staten Island, NY
  • NPI 1407877137
  Care Compare affiliation

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208131200000",
    "number": "1043287857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 AIRDALE DR",
            "city": "KENDALL PARK",
            "state": "NJ",
            "postal_code": "088241494",
            "telephone_number": "718-448-1122",
            "fax_number": "718-448-8318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 TODT HILL RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144528",
            "telephone_number": "718-448-1122",
            "fax_number": "718-448-8318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "WALLEN",
        "middle_name": "CY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2008-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "183203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01768538",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristina Chan
• Kwun Y Chan, RN
• Peggy Chan, M.D.
• Samuel Chan
• Siu-Pun Chan, MD
• Yeoman Kin-Lung Chan, MD
• Yun Wa Chan
• Helen Chandler
• Vijaya Lakshmi Chandrakant, MD
• Dalia Chandy, SLP

• Gastroenterology Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.