Individual provider Active NPI

Tony Chan

  • Psychiatry Physician
  • Oakland, CA
National Provider Identifier
1043639222
Registry record updated Nov 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
1043639222 Issued in CA
Practice address
2940 Summit St
Oakland, CA 94609-3416
Phone
(510) 519-6429
NPI assigned
Apr 15, 2014
Last updated
Nov 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 1043639222 CA Primary

Addresses

Primary practice location

2940 Summit St
Oakland, CA 94609-3416

Mailing address

1250 Fairmont Dr Ste a
San Leandro, CA 94578-3547
Phone (510) 519-6429

Other practice location 1

2351 Clay St Ste 380
San Francisco, CA 94115-1931
Phone (415) 600-3954

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160628000960 CA Practitioner - Psychiatry 4183915853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.17 of 100Reported as group
Quality
86.93
Promoting interoperability
100
Improvement activities
40
Cost
72.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1043639222CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda Health System CurrentSince May 30, 2016 Accepting new patients
Alameda Health System CurrentSince May 30, 2016 Accepting new patients

Locations

15400 Foothill Blvd
Castro Valley, CA 94578
Phone (510) 346-1468

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

Interoperability endpoints

  • Direct secure messaging: tchan10249@alamedahs.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542412800000",
    "number": "1043639222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 FAIRMONT DR STE A",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945783547",
            "telephone_number": "510-519-6429",
            "fax_number": "864-810-6629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 SUMMIT ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093416",
            "telephone_number": "510-519-6429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2351 Clay St Ste 380",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941151931",
            "country_code": "US",
            "telephone_number": "415-600-3954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "TONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2018-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "1043639222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.