Benjamin Chan, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

62052 Issued in CT

Practice address

31 Old Route 7
Brookfield, CT 06804-1711

Phone

(203) 885-0808

Fax

(203) 885-0813

NPI assigned

Jun 27, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Emergency Medicine

Education

State University of New York Downstate Medical Center, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore Lij Urgent Care PC 389 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Phelps Hospital Hospital, Sleepy Hollow, NY, CCN 330261

Merit-based Incentive Payment System (MIPS)

Final score

93.07 of 100Reported as apm

Quality

79.77

Promoting interoperability

88.77

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: benjamin.chan@ghuc.eclinicaldirectplus.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.

• North Shore Lij, Urgent Care, P.C.

  • Urgent Care Clinic/Center
  • Rockville Centre, NY
  • NPI 1679970891

  NY

  Medicare reassignment Care Compare group NPD
• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572

  Emergency Medicine, NY

  Medicare reassignment NPD
• Optum Medical Care, P.C.

  • Cardiovascular Disease Physician
  • Mount Kisco, NY
  • NPI 1982643003

  NY

  Medicare reassignment NPD
• Optum Medical Care, P.C.

  • Durable Medical Equipment & Medical Supplies
  • New Hyde Park, NY
  • NPI 1053190595
  NPD
• UC of Mamaroneck, LLC

  • Urgent Care Clinic/Center
  • Mamaroneck, NY
  • NPI 1023667482
  NPD
• Urgent Care of Ridgefield, LLC

  • Urgent Care Clinic/Center
  • Ridgefield, CT
  • NPI 1427344860
  NPD (past)
• WRK Ventures, LLC

  • Urgent Care Clinic/Center
  • Southbury, CT
  • NPI 1194993980
  NPD (past)

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

• Phelps Memorial Hospital Association

  • General Acute Care Hospital
  • Sleepy Hollow, NY
  • NPI 1720185267

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1043574718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E MAIN ST",
            "address_2": "NWH ED C/O CAROL FORREST",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493417",
            "telephone_number": "914-666-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 OLD ROUTE 7",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068041711",
            "telephone_number": "203-885-0808",
            "fax_number": "203-885-0813"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 E Main St",
            "address_2": "NWH ED c/o Carol Forrest",
            "address_purpose": "LOCATION",
            "city": "Mount Kisco",
            "state": "NY",
            "postal_code": "105493417",
            "country_code": "US",
            "telephone_number": "914-666-1254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-27",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "282522",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "62052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Traci Casey, MS CCC SLP TSHH
• Amanda Rose Castro
• Joseph Caverly, PSY.D.
• Catarina Cecilio
• Shirley Celestin
• Christopher Chapleau, L.AC.
• Jill Wendy Chaus Carnes, MS, LCSW
• Tammy Chelednik, M.S.
• Carina Chelso, LCSW
• Fanny Miufun Chiang, RPH

• All providers in Brookfield, CT
• Emergency Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; 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.