Individual provider Active NPI

Andy Chan

  • Social Worker
  • Brooklyn, NY
National Provider Identifier
1043942428
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
100900 Issued in NY
Practice address
1828 82ND St
Brooklyn, NY 11214-2288
Phone
(347) 257-5584
NPI assigned
Jun 25, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 100900 NY Primary

Addresses

Primary practice location

1828 82ND St
Brooklyn, NY 11214-2288

Mailing address

1828 82ND St
Brooklyn, NY 11214-2288
Phone (347) 257-5584

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
100900NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1656115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1043942428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1828 82ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112142288",
            "telephone_number": "347-257-5584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1828 82ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112142288",
            "telephone_number": "347-257-5584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "ANDY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-25",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "100900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.