Individual provider Active NPI

Paul C Chan, MD

  • Urology Physician
  • Arlington, TX
National Provider Identifier
1386630879
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
K8059 Issued in TX
Practice address
5005 S Cooper St Ste 250
Arlington, TX 76017-5996
Phone
(866) 367-8768
Fax
(817) 541-9540
NPI assigned
Sep 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X K8059 TX Primary

Addresses

Primary practice location

5005 S Cooper St Ste 250
Arlington, TX 76017-5996

Mailing address

5001 S Cooper St Ste 201
Arlington, TX 76017-5993
Phone (866) 367-8768

Other identifiers 5

IdentifierTypeStateIssuer
116357804MedicaidTX
116357805OtherTXMEDICAID OTHER
116357801MedicaidTX
116357803MedicaidTX
116357806MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20080509000048 TX Practitioner - Urology 6406935915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5005 S Cooper St
Suite 250
Arlington, TX 76017-5996
Phone (866) 367-8768

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.29 of 100Reported as group
Quality
91.85
Promoting interoperability
77
Improvement activities
40
Cost
74.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0000000TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Partners of North Texas, PLLC Urology CurrentSince Apr 6, 2019 Accepting new patients
Urology Partners of North Texas, PLLC Urology PastSince Dec 16, 2020 Accepting new patients
Urology Associates of North Texas LLP Urology Past Accepting new patients
Usmd Diagnostic Services, LLC PastSince Sep 1, 2012 Accepting new patients

Locations

3301 Matlock Rd
Arlington, TX 76015
Phone (682) 509-6200

5001 S Cooper St
Ste 201
Arlington, TX 76017

5005 S Cooper St
Ste 250
Arlington, TX 76017

6800 N MacArthur Blvd
Irving, TX 75039
Phone (972) 969-2000

945 Hilltop Dr
Ste 100
Weatherford, TX 76086
Phone (817) 550-6332

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/18f5d65c-83f0-435a-868c-70ce5a6de90a/

Organizations & group practices 4

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": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1386630879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 S COOPER ST STE 201",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760175993",
            "telephone_number": "866-367-8768",
            "fax_number": "817-541-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 S COOPER ST STE 250",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760175996",
            "telephone_number": "866-367-8768",
            "fax_number": "817-541-9540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "PAUL",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "K8059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116357804",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID OTHER",
            "identifier": "116357805",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116357801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116357803",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116357806",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

Verify at the official NPI Registry.