Patricia Meyer Chan, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2396057 Issued in WI

Practice address

5800 N Bay Shore Dr
Suite A250
Glendale, WI 53217

Phone

(414) 962-6764

Fax

(414) 962-6765

NPI assigned

Nov 1, 2006

Last updated

Nov 14, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

University of Wisconsin School of Medicine, 2000

Medicare assignment

May accept Medicare assignment

Group practices

North Shore Psychotherapy Associates IVGroup PAC ID 7911287461, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• North Shore Psychotherapy Associates IV

  dba Nspa

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Glendale, WI
  • NPI 1194809574

  Clinical

  Medicare reassignment Care Compare group NPD
• Achievement Associates, LTD

  • Clinical Psychologist
  • Mequon, WI
  • NPI 1154365971
  NPD (past)
• Apps Chiropractic and Wellness Center Inc

  • Chiropractor
  • Wauwatosa, WI
  • NPI 1336276625
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352851200000",
    "number": "1215015193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 N BAY SHORE DR",
            "address_2": "SUITE A250",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "53217",
            "telephone_number": "414-962-6764",
            "fax_number": "414-962-6765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 N BAY SHORE DR",
            "address_2": "SUITE A250",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "53217",
            "telephone_number": "414-962-6764",
            "fax_number": "414-962-6765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER CHAN",
        "first_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2396057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43575100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Medpoint Physical Therapy
• Medpoint Urgent Care, LLC
• Nancy L Megan, MD
• David William Meister, M.D.
• Lakisha Metcalf, PEER SPECIALIST
• Courtney F Meyer, FNP
• Katelyn Ruth Michals, L.AC.
• Austin Hugh Middleton, MD
• Donald Kevin Middleton, MD
• Midwest Dialysis Center, Inc (Midwest Dialysis Center-Glendale Branch)

• Clinical Psychologist in Glendale, WI
• Providers in Glendale, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2012; 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.