Individual provider Active NPI

Tricia Chan, MD

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1326131616
Registry record updated Jan 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
221910 Issued in NY
Practice address
1650 Grand Concourse
Acn Medical Clinic 2ND Floor
Bronx, NY 10457-7606
Phone
(718) 590-1800
Fax
(718) 518-5740
NPI assigned
Oct 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 221910 NY Primary

Addresses

Primary practice location

1650 Grand Concourse
Acn Medical Clinic 2ND Floor
Bronx, NY 10457-7606

Mailing address

1650 Grand Concourse
Acn Medical Clinic 2ND Floor
Bronx, NY 10457-7606
Phone (718) 590-1800

Other identifiers 1

IdentifierTypeStateIssuer
02194392MedicaidNY

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
I20110217000770 NY Practitioner - Internal Medicine 2466633870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Icahn School of Medicine at Mount Sinai, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bronxcare Health SystemGroup PAC ID 3870404429, 335 clinicians

Practice addresses (Care Compare)

1650 Grand Concourse
Bronx, NY 10457-7606

199 Mount Eden Pkwy
Bronx, NY 10457-7703

199 Mount Eden Pkwy 3
Bronx Lebanon Ambulatory Care
Bronx, NY 10457-7703
Phone (718) 992-7669

199 Mount Eden Pkwy 3Rd
Bronx Lebanon Ambulatory Care
Bronx, NY 10457-7703
Phone (718) 992-7669

199 Mount Eden Pkwy Floor
3 Bronx Lebanon Healthandwellness Center
Bronx, NY 10457-7703
Phone (718) 992-7669

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System Internal Medicine CurrentSince Jan 1, 1992 Accepting new patients
Bronxcare Health System Past Accepting new patients

Locations

1276 Fulton Ave
Rm 208
Bronx, NY 10456
Phone (718) 901-8918

1650 Grand Concourse
Fl 2
Bronx, NY 10457
Phone (718) 518-5060

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

Networks

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

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1159660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1326131616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 GRAND CONCOURSE",
            "address_2": "ACN MEDICAL CLINIC 2ND FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577606",
            "telephone_number": "718-590-1800",
            "fax_number": "718-518-5740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 GRAND CONCOURSE",
            "address_2": "ACN MEDICAL CLINIC 2ND FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577606",
            "telephone_number": "718-590-1800",
            "fax_number": "718-518-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "TRICIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-01",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "221910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02194392",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.