Tina Chan, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

16515 Issued in NY

Practice address

156 W 56TH St Ste 1804
New York, NY 10019-3878

Phone

(212) 851-8102

Fax

(888) 977-2547

NPI assigned

Jul 26, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clinical Psychassociates LLPGroup PAC ID 3072404888, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Clinical Psychassociates LLP

  • Clinical Psychologist
  • New York, NY
  • NPI 1124051925
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525651200000",
    "number": "1407870348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 OLD STONE HILL RD",
            "city": "POUND RIDGE",
            "state": "NY",
            "postal_code": "105761518",
            "telephone_number": "860-748-8709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 W 56TH ST STE 1804",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193878",
            "telephone_number": "212-851-8102",
            "fax_number": "888-977-2547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "TINA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2018-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "16515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02708661",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa T Chan, MD
• Thomas K Chan, MD
• Tiffany Chan, MD
• Timothy An-Thy Chan, MD, PHD
• Tina Chan, O.D.
• Tsoi Nam Chan
• Tzu-Hui Chan, O.T.
• Vincent Chan, M.D.
• Virginia Marie Chan
• Vivian Lap Wing Chan

• Clinical Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; 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.