Individual provider Active NPI

Germaine Z Chan, M.D.

  • Nephrology Physician
  • New York, NY
National Provider Identifier
1396738332
Registry record updated Apr 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
187631-1 Issued in NY
Practice address
1090 Amsterdam Ave
10TH Floor
New York, NY 10025-1737
Phone
(212) 961-5530
Fax
(212) 531-7650
NPI assigned
Aug 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 187631-1 NY Primary

Addresses

Primary practice location

1090 Amsterdam Ave
10TH Floor
New York, NY 10025-1737

Mailing address

PO Box 95000-4145
Philadelphia, PA 19195-0001
Phone (212) 315-0144

Other identifiers 1

IdentifierTypeStateIssuer
02134072MedicaidNY

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
I20070613000525 NY Practitioner - Nephrology 3072611144 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
187631-1NYMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai Nephrology CurrentSince Nov 1, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 1, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
SLR FPP University Medical Practice Associates Nephrology Past Accepting new patients
Slrhc Faculty Practice Past Accepting new patients

Locations

1090 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2211

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

150 E 42nd St
Fl 9
New York, NY 10017
Phone (646) 605-8119

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

425 W 59th St
Ste 9C
New York, NY 10019
Phone (212) 492-5550

1090 Amsterdam Ave
Fl 10
New York, NY 10025
Phone (212) 523-2184

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1396738332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000-4145",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191950001",
            "telephone_number": "212-315-0144",
            "fax_number": "212-315-0196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 AMSTERDAM AVE",
            "address_2": "10TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251737",
            "telephone_number": "212-961-5530",
            "fax_number": "212-531-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "GERMAINE",
        "middle_name": "Z",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-24",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "187631-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02134072",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.