Individual provider Active NPI

Chanelle C Durand, MD

  • Family Medicine Physician
  • Bayonne, NJ
National Provider Identifier
1073257879
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA12683200 Issued in NJ
Practice address
988 Broadway
Bayonne, NJ 07002-4036
Phone
(201) 339-6111
NPI assigned
Apr 26, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA12683200 NJ Primary

Addresses

Primary practice location

988 Broadway
Bayonne, NJ 07002-4036

Mailing address

1210 Woodbridge Commons Way
Iselin, NJ 08830-3028
Phone (717) 719-9858

Other practice location 1

1125 N College Ave
Fayetteville, AR 72703-1908
Phone (479) 521-8260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20250919003256 NJ Practitioner - Family Practice 7810491925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
BHMG - United MedicalGroup PAC ID 5193949865, 28 clinicians

Practice addresses (Care Compare)

988 Broadway
Suite 201
Bayonne, NJ 07002-4036
Phone (201) 339-6111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA12683200NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BHMG - United Medical Family Medicine CurrentSince Jul 8, 2025 Accepting new patients
Rapid Access Medical Diagnostics NJ LLC PastSince Jul 9, 2025 Accepting new patients

Locations

988 Broadway
Bayonne, NJ 07002
Phone (201) 339-6111

988 Broadway
Ste 201
Bayonne, NJ 07002
Phone (201) 339-6111

612 Rutherford Ave
Lyndhurst, NJ 07071
Phone (200) 460-0063

Interoperability endpoints

  • Direct secure messaging: cdurand50208@washingtonregional.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": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1073257879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 WOODBRIDGE COMMONS WAY",
            "city": "ISELIN",
            "state": "NJ",
            "postal_code": "088303028",
            "telephone_number": "717-719-9858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "988 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070024036",
            "telephone_number": "201-339-6111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 N College Ave",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "727031908",
            "country_code": "US",
            "telephone_number": "479-521-8260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DURAND",
        "first_name": "CHANELLE",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-26",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA12683200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

Verify at the official NPI Registry.