Jack Sui Ki Chan, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD60179402 Issued in WA

Practice address

1350 N Town Center Dr Unit 1033
Las Vegas, NV 89144-0577

Phone

(517) 899-5453

NPI assigned

Jul 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, NV, AK, OR, TN5 enrollments

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 5

Specialty

Emergency Medicine

Education

University of Vermont College of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Olney Emergency Group, a Professional LLCGroup PAC ID 8426399965, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Alaska Regional Hospital Hospital, Anchorage, AK, CCN 020017
• Physicians Regional Medical Center Hospital, Powell, TN, CCN 440120
• Astria Toppenish Hospital Hospital, Toppenish, WA, CCN 500037
• Starr Regional Medical Center Athens Hospital, Athens, TN, CCN 440068
• Forks Community Hospital Hospital, Forks, WA, CCN 501325

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Olney Emergency Group, a Professional LLC

  • Emergency Medicine Physician
  • Toppenish, WA
  • NPI 1386108868
  Medicare reassignment Care Compare group NPD
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  TN

  Medicare reassignment Care Compare group NPD
• Sound Physicians Emergency Medicine of Nevada Bessler PLLC

  • Emergency Medicine Physician
  • Sparks, NV
  • NPI 1881151231
  Medicare reassignment NPD
• Asante

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Medicare reassignment NPD
• Clallam County Public Hospital District No 1

  • Critical Access Hospital
  • Forks, WA
  • NPI 1891879680
  Medicare reassignment NPD
• Denali Emergency Medicine Assoc PC

  • Emergency Medicine Physician
  • Anchorage, AK
  • NPI 1669406831
  Medicare reassignment NPD
• Emergency Medicine Services of TN, PC

  • Emergency Medicine Physician
  • Nashville, TN
  • NPI 1720785884
  Medicare reassignment NPD
• Golden Heart Emergency Physicians, Inc.

  • Emergency Medicine Physician
  • Fairbanks, AK
  • NPI 1649469446
  Medicare reassignment NPD
• Sound Physicians Emergency Medicine of Washington PLLC

  • Emergency Medicine Physician
  • Sedro Woolley, WA
  • NPI 1629532064
  Medicare reassignment NPD
• Sunnyside Emergency Group a Professional LLC

  • Emergency Medicine Physician
  • Sunnyside, WA
  • NPI 1033529367
  Medicare reassignment NPD
• Washington Emergency Physician Partners PLLC

  • Emergency Medicine Physician
  • Kennewick, WA
  • NPI 1346586351
  Medicare reassignment NPD
• Spring Creek Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Chattanooga, TN
  • NPI 1275961799
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Athens Regional Medical Center LLC

  • General Acute Care Hospital
  • Athens, TN
  • NPI 1669567319
  Care Compare affiliation
• Clallam County Public Hospital District No 1

  • Critical Access Hospital
  • Forks, WA
  • NPI 1891879680
  Care Compare affiliation
• Galen Hospital Alaska, Inc.

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1952348047
  Care Compare affiliation
• Metro Knoxville Hma LLC

  • General Acute Care Hospital
  • Powell, TN
  • NPI 1043292899
  Care Compare affiliation
• SHC Medical Center Toppenish

  • General Acute Care Hospital
  • Toppenish, WA
  • NPI 1851817308
  Care Compare affiliation

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1376741256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 N TOWN CENTER DR UNIT 1033",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891440577",
            "telephone_number": "517-899-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 N TOWN CENTER DR UNIT 1033",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891440577",
            "telephone_number": "517-899-5453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JACK",
        "middle_name": "SUI KI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD60179402",
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MI",
            "license": "4301090230",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gloria Sui Chun Chan
• Hans Lester S Chan
• Helen Chan
• Howard Chan, D.D.S.
• Hui Ching Chan
• Jennifer Chan
• Johnny Chung-Yin Chan
• Joy Chan
• Kaylin Chan
• Kimneang Chan

• Emergency Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Emergency Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.