NPIMap

Individual provider Active NPI

Edwin Chan, MD

  • Family Medicine Physician
  • Palm Bay, FL
National Provider Identifier
1124142054
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME104439 Issued in FL
Practice address
1810 Eldron Blvd SE
Palm Bay, FL 32909-6831
Phone
(321) 576-0645
Fax
(321) 409-6812
NPI assigned
Mar 17, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 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 ME104439 FL Primary

Addresses

Primary practice location

1810 Eldron Blvd SE
Palm Bay, FL 32909-6831

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (321) 576-0645

Other identifiers 1

IdentifierTypeStateIssuer
VB775OtherFLMEDICARE HF

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091002000219 FL Practitioner - Family PracticePractitioner - Internal Medicine 5991853061 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Health First Medical Group, LLCGroup PAC ID 7416100672, 701 clinicians

Practice addresses (Care Compare)

1810 Eldron Blvd SE
Palm Bay, FL 32909-6831
Phone (321) 434-1981

699 W Cocoa Beach Cswy
Cocoa Beach, FL 32931-3562

7125 Murrell Rd
Viera, FL 32940-7999
Phone (321) 242-8790

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME104439FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health First Medical Group, LLC CurrentSince Jun 20, 2025 Accepting new patients
Suntree Endocrinology Current Accepting new patients
Health First Medical Group, LLC Family Medicine CurrentSince Jun 20, 2025 Accepting new patients
Community Memorial Hospital Past Accepting new patients

Locations

699 W Cocoa Beach Cswy
Ste 405
Cocoa Beach, FL 32931
Phone (321) 868-7272

6619 N Wickham Rd
Melbourne, FL 32940
Phone (321) 259-9500

1810 Eldron Blvd SE
Palm Bay, FL 32909
Phone (321) 312-3466

3300 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 434-1771

Interoperability endpoints

  • Direct secure messaging: echan139547@epicdirect.hf.org

Organizations & group practices 5

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1174089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1124142054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "321-576-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 ELDRON BLVD SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329096831",
            "telephone_number": "321-576-0645",
            "fax_number": "321-409-6812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-17",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME104439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE HF",
            "identifier": "VB775",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

Verify at the official NPI Registry.