Jon Michael Chan, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

036.144383 Issued in IL

Practice address

65 Oakland PL
Buffalo, NY 14222-2041

Phone

(614) 366-3687

NPI assigned

Jul 31, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA, IL, NY, ND4 enrollments

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 4

Specialty

Otolaryngology

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jchan178625@direct-guthrie.org

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.

• Sanford Medical Center Fargo

  dba Sanford 1717 Medical Building

  • Family Medicine Physician
  • West Fargo, ND
  • NPI 1184917924
  Medicare reassignment Care Compare group NPD
• Guthrie Medical Group, P.C.

  • Multi-Specialty Clinic/Center
  • Corning, NY
  • NPI 1134178635
  Medicare reassignment NPD
• Guthrie Medical Group, P.C.

  • Family Medicine Physician
  • Athens, PA
  • NPI 1962451153
  Medicare reassignment NPD
• Rockford Health Physicians

  dba Mercyhealth Physicians

  • Multi-Specialty Clinic/Center
  • Rockford, IL
  • NPI 1043242886
  Medicare reassignment NPD
• Susquehanna Physician Services

  dba Susquehanna Health Medical Group

  • Otolaryngology Physician
  • Williamsport, PA
  • NPI 1346263266
  Medicare reassignment NPD
• Guthrie Medical Group, P.C.

  • General Practice Physician
  • Sayre, PA
  • NPI 1245246644
  NPD
• Guthrie Medical Group, P.C.

  • Otolaryngology Physician
  • Sayre, PA
  • NPI 1760434112
  NPD
• Sanford Medical Center Fargo

  dba Sanford Ellendale Clinic

  • Rural Health Clinic/Center
  • Ellendale, ND
  • NPI 1346256682
  NPD
• Sanford Medical Center Fargo

  dba Sanford POWER Center

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1528009412
  NPD
• Susquehanna Physician Services

  • Radiology Clinic/Center
  • Mansfield, PA
  • NPI 1073361564
  NPD
• Sanford Medical Center Fargo

  dba Sanford Home Care

  • Home Health Agency
  • Fargo, ND
  • NPI 1891861761
  NPD (past)

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

• Sanford Health of Northern Minnesota

  dba Sanford Bemidji

  • Ambulatory Surgical Clinic/Center
  • Bemidji, MN
  • NPI 1093876922

  Hospital

  Care Compare affiliation
• Sanford Medical Center Fargo

  dba Sanford 1717 Medical Building

  • Family Medicine Physician
  • West Fargo, ND
  • NPI 1184917924

  Hospital

  Care Compare affiliation
• Sanford Medical Center Fargo

  dba Sanford Physical Therapy

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1245519081
  Care Compare affiliation
• Sanford Medical Center Fargo

  dba Sanford POWER Center

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1528009412
  Care Compare affiliation
• Sanford Medical Center Fargo

  • Air Ambulance
  • Fargo, ND
  • NPI 1942415468

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1053577924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 OAKLAND PL",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142222041",
            "telephone_number": "614-366-3687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 OAKLAND PL",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142222041",
            "telephone_number": "614-366-3687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3316 Patriot Ct",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483782",
            "country_code": "US",
            "telephone_number": "618-993-0307",
            "fax_number": "618-993-0807",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 W 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101280",
            "country_code": "US",
            "telephone_number": "614-293-8074",
            "fax_number": "614-293-3193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-31",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "35.120793",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036.144383",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "293812",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MT193950",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "ND",
            "license": "23031",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "293812",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jon.m.chan@upmcdirect.com",
            "affiliation": "N",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarah Chamberlin, RN
• Daisy Chambers, MSW
• Michael Chambers
• Andrew Chan, DDS
• Arthur Chan
• Kevin Kuang Hui Chan, DO
• Meagan Chandarana, PHARMD
• Unjali Chandra
• Praveen Kumar Chandrasekharan, MD
• Chanel Freeman NP in Psychiatry PLLC

• Otolaryngology Physician in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Otolaryngology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; 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.