Inspira Dermatology PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

250588 Issued in NY

Legal business name

INSPIRA DERMATOLOGY PLLC

Practice address

13636 39TH Ave
5TH Floor
Flushing, NY 11354-5599

Phone

(718) 509-6475

Fax

(718) 509-6467

NPI assigned

Mar 23, 2017

Organization subpart

No

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

Authorized official

Name

Wai Ping Chan, D.O.NPI 1033354428

Title

Physician

Phone

(718) 509-6475

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Wai Ping Chan, D.O.

  • Dermatology Physician
  • Flushing, NY
  • NPI 1033354428
  Medicare reassignment Authorized official
• Emily Yeung

  • Physician Assistant
  • Fresh Meadows, NY
  • NPI 1366065039
  NPD (past)

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490227200000",
    "number": "1255862025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13636 39TH AVE",
            "address_2": "5TH FLOOR",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545599",
            "telephone_number": "718-509-6475",
            "fax_number": "718-509-6467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13636 39TH AVE",
            "address_2": "5TH FLOOR",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545599",
            "telephone_number": "718-509-6475",
            "fax_number": "718-509-6467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSPIRA DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-23",
        "last_updated": "2017-03-23",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "WAI",
        "authorized_official_middle_name": "PING",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "718-509-6475",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NY",
            "license": "250588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Flushing, NY
• Providers in Flushing, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.