Individual provider Active NPI

Eric Chan, MD

  • Family Medicine Physician
National Provider Identifier
1114617099
Registry record updated Oct 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
210946 Issued in AK
Practice address
Unit 2060 Box 51St
Apo, AP 96278-2060
Phone
(210) 758-4593
NPI assigned
May 12, 2023
Last updated
Oct 5, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2026

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 210946 AK Primary

Addresses

Primary practice location

Unit 2060 Box 51St
Apo, AP 96278-2060

Mailing address

Unit 2060 Box 51St
Apo, AP 96278-2060

Other practice location 1

1201 E 36th Ave
Anchorage, AK 99508-4372
Phone (907) 562-9229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20230808000964 AK Order and Referring Only - Family PracticePractitioner - Family Practice 1951763945

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
210946AKMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1683849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791158400000",
    "number": "1114617099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "UNIT 2060 BOX 51ST",
            "city": "APO",
            "state": "AP",
            "postal_code": "962782060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "MIL",
            "address_1": "UNIT 2060 BOX 51ST",
            "city": "APO",
            "state": "AP",
            "postal_code": "962782060",
            "telephone_number": "210-758-4593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 E 36th Ave",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995084372",
            "country_code": "US",
            "telephone_number": "907-562-9229",
            "fax_number": "907-562-1603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "ERIC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-12",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "210946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.