Individual provider Active NPI

Don Jason Villavelez Chan, PT, DPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1407543457
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
041347 Issued in NY
Practice address
1345 Avenue of the Americas FL 15
New York, NY 10105-0021
Phone
(212) 981-1977
Fax
(646) 786-4026
NPI assigned
Apr 20, 2023
Last updated
Apr 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 041347 NY Primary

Addresses

Primary practice location

1345 Avenue of the Americas FL 15
New York, NY 10105-0021

Mailing address

19 Locust Street
Massapequa, NY 11758
Phone (516) 724-4212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260227002624 NY Practitioner - Physical Therapist in Private Practice 2567943418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affinity Rehabilitation LLPGroup PAC ID 4789843376, 114 clinicians

Practice addresses (Care Compare)

1 Sunrise Dr
East Setauket, NY 11733-3820
Phone (631) 459-5498

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041347NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Rehabilitation LLP CurrentSince Jan 21, 2026 Accepting new patients

Locations

1 Sunrise Dr
East Setauket, NY 11733
Phone (631) 459-5498

500 N Columbus Ave
Mount Vernon, NY 10552
Phone (914) 266-3796

1 Johnsarbor Dr W
Rochester, NY 14620
Phone (585) 532-7214

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1681948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1407543457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 LOCUST STREET",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "11758",
            "telephone_number": "516-724-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 AVENUE OF THE AMERICAS FL 15",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101050021",
            "telephone_number": "212-981-1977",
            "fax_number": "646-786-4026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "DON JASON",
        "middle_name": "VILLAVELEZ",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-20",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "041347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.