Individual provider Active NPI

Sydney Chan

  • Audiologist
  • Silver Spring, MD
National Provider Identifier
1306482039
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
2415 Musgrove Rd Ste 306
Silver Spring, MD 20904-5205
Phone
(301) 384-5977
NPI assigned
Nov 18, 2019
Reactivated
Dec 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Audiologist 231H00000X Primary

Addresses

Primary practice location

2415 Musgrove Rd Ste 306
Silver Spring, MD 20904-5205

Mailing address

6000 Merriweather Dr Unit 7050
Columbia, MD 21044-4464
Phone (916) 802-4625

Other practice location 1

3336 Bradshaw Rd Ste 140
Sacramento, CA 95827-2697
Phone (916) 245-4133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250725004257 DC Practitioner - Qualified Audiologist 7911414867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Pacific Medical College, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

2440 M St NW
801 Henry B Fox MD
Washington, DC 20037-1474
Phone (202) 296-2440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01696MDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince May 8, 2025 Accepting new patients
Privia Medical Group, LLC CurrentSince May 8, 2025 Accepting new patients

Locations

2440 M St NW
Ste 801
Washington, DC 20037
Phone (202) 296-2181

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

2415 Musgrove Rd
Ste 306
Silver Spring, MD 20904
Phone (240) 293-5791

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

Interoperability endpoints

  • Direct secure messaging: sydney.chan.1@8042.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1306482039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 MERRIWEATHER DR UNIT 7050",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210444464",
            "telephone_number": "916-802-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 MUSGROVE RD STE 306",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209045205",
            "telephone_number": "301-384-5977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3336 Bradshaw Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958272697",
            "country_code": "US",
            "telephone_number": "916-245-4133",
            "fax_number": "855-568-2494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "SYDNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "deactivation_date": "2024-11-27",
        "reactivation_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.