Individual provider Active NPI

Ying Chan, MD

  • Maternal & Fetal Medicine Physician
  • Flushing, NY
National Provider Identifier
1174557979
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
2068741 Issued in NY
Practice address
13336 41St Rd Ste 2a
Flushing, NY 11355-3666
Phone
(718) 268-0008
Fax
(347) 851-1209
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X 25MA05936800 NJ
Health Service Clinic/Center 261QH0100X 2068741 NY
Maternal & Fetal Medicine Physician 207VM0101X 2068741 NY Primary

Addresses

Primary practice location

13336 41St Rd Ste 2a
Flushing, NY 11355-3666

Mailing address

13336 41St Rd
Suite 2a
Flushing, NY 11355-3666
Phone (718) 268-0008

Other practice location 1

837 59th St Fl 2
Brooklyn, NY 11220-5577
Phone (718) 268-0010

Other identifiers 2

IdentifierTypeStateIssuer
8422206MedicaidNJ
08199783MedicaidNY

Other names 1

  • Ying Chan-Mark Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20140825001784 NY Practitioner - Obstetrics/GynecologyPractitioner - Other (Physician) 0941445142 Reassigns benefits to 1 organization
Practice locations: Brooklyn, NY; Flushing, NY

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
State University of New York at Stony Brook, School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13336 41St Rd
Flushing, NY 11355-3666
Phone (718) 268-0010

14453 Jewel Ave
Flushing, NY 11367-1722

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2068741NYMDHealth Service Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Feb 22, 2020 Accepting new patients
Comprehensive Perinatal Medicine PLLC Maternal & Fetal Medicine CurrentSince Apr 8, 2014 Accepting new patients
Nick Yoon Physical Therapy P.C. Past Accepting new patients
Century Dermatology PC PastSince Dec 16, 2020 Accepting new patients
Practice Associates,Inc Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Plandome, NY 11030

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: yingchan@nslijmedgr.allscriptsdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1174557979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13336 41ST RD",
            "address_2": "SUITE 2A",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553666",
            "telephone_number": "718-268-0008",
            "fax_number": "718-744-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13336 41ST RD STE 2A",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553666",
            "telephone_number": "718-268-0008",
            "fax_number": "347-851-1209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "837 59th St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112205577",
            "country_code": "US",
            "telephone_number": "718-268-0010",
            "fax_number": "347-851-1209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "YING",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "NJ",
            "license": "25MA05936800",
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NY",
            "license": "2068741",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "NY",
            "license": "2068741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8422206",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08199783",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YING",
            "last_name": "CHAN-MARK",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.