NPIMap

Individual provider Active NPI

Jimmy Chan

  • Orthopaedic Surgery Physician
  • Scarsdale, NY
National Provider Identifier
1366898645
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
290437 Issued in NY
Practice address
7 Hidden Ridge CT
Scarsdale, NY 10583-4624
Phone
(914) 471-0667
NPI assigned
May 5, 2016
Last updated
Nov 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Orthopaedic Surgery Physician 207X00000X 290437 NY Primary

Addresses

Primary practice location

7 Hidden Ridge CT
Scarsdale, NY 10583-4624

Mailing address

555 Central Park Ave
Apt 112
Scarsdale, NY 10583-1049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201026001799 NY Practitioner - Orthopedic Surgery 5799021036 Reassigns benefits to 3 organizations
I20250602002692 NJ Practitioner - Orthopedic SurgeryPractitioner - Hand Surgery 5799021036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Albert Einstein College of Medicine of Yeshiva University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

122 Maple Ave
White Plains, NY 10601-4706
Phone (914) 285-9808

130 E 77TH St
FL 7
New York, NY 10075-1851
Phone (914) 471-0667

541 Cedar Hill Ave
Suite 1
Wyckoff, NJ 07481-2133
Phone (201) 904-2121

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jimmy Chan MD PLLC Orthopaedic Surgery CurrentSince Aug 26, 2024 Accepting new patients
White Plains Physician Services PC CurrentSince Oct 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Orthopaedic Surgery CurrentSince Jul 1, 2020 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2020 Accepting new patients
White Plains Hospital Medical Center Past Accepting new patients

Locations

541 Cedar Hill Ave
Ste 1
Wyckoff, NJ 07481
Phone (201) 240-1593

7901 Broadway
Rm A119
Elmhurst, NY 11373
Phone (718) 334-4951

185 Kisco Ave
Ste 300
Mount Kisco, NY 10549
Phone (914) 242-2020

130 E 77th St
Fl 7
New York, NY 10075
Phone (212) 744-8114

656 Central Park Ave
Scarsdale, NY 10583

750 White Plains Rd
Scarsdale, NY 10583
Phone (914) 597-3880

122 Maple Ave
White Plains, NY 10601
Phone (914) 285-9490

122 Maple Ave
Fl 8
White Plains, NY 10601
Phone (914) 787-3297

222 Westchester Ave
Ste 101
White Plains, NY 10604
Phone 9149461010324

Networks

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

Interoperability endpoints

  • Direct secure messaging: jchan66700@northwell.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1462406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1366898645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 CENTRAL PARK AVE",
            "address_2": "APT 112",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105831049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 HIDDEN RIDGE CT",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105834624",
            "telephone_number": "914-471-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JIMMY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-05",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "290437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarsdale, NY

Sources for this page

Verify at the official NPI Registry.