Individual provider Active NPI

Jeffrey Chan, MD

  • Surgery Physician
  • Jamaica, NY
National Provider Identifier
1417918343
Registry record updated Feb 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
206686 Issued in NY
Practice address
8906 135TH St
Suite 2T
Jamaica, NY 11418-2821
Phone
(718) 206-7110
Fax
(718) 206-7111
NPI assigned
Mar 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 206686 NY Primary

Addresses

Primary practice location

8906 135TH St
Suite 2T
Jamaica, NY 11418-2821

Mailing address

80 Marcus Dr
Provider Enrollment
Melville, NY 11747-4230
Phone (631) 391-7889

Other identifiers 1

IdentifierTypeStateIssuer
01755004MedicaidNY

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
I20100928000161 NY Practitioner - General Surgery 6507982584 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Boston University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jamaica HospitalGroup PAC ID 2264324334, 252 clinicians
TJH Medical Services PCGroup PAC ID 8527960533, 215 clinicians

Practice addresses (Care Compare)

11120 Merrick Blvd
Jamaica, NY 11433-4016
Phone (718) 206-9888

120 46 Queens Blvd
Kew Gardens, NY 11415
Phone (718) 006-6708

13303 Jamaica Ave
Richmond Hill, NY 11418-2618
Phone (718) 291-3276

89 -40
Jamaica, NY 11418-2832
Phone (718) 206-5200

8900 Van Wyck Expressway
Jamaica, NY 11418-2832

8900 Van Wyck Expressway
4 Floor C Building
Jamaica, NY 11418-2821
Phone (718) 206-6894

8900 Van Wyck Expy
Jamaica, NY 11418-2832

8906 135TH St
Jamaica, NY 11418-2821

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.19 of 100Reported as group
Quality
82.16
Promoting interoperability
79
Improvement activities
40
Cost
75.98

Merit-based Incentive Payment System (MIPS)

Final score
85.41 of 100Reported as group
Quality
64.77
Promoting interoperability
79
Improvement activities
40
Cost
70.76

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
206686NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Flushing Hospital & Medical Center CurrentSince Aug 15, 2013 Accepting new patients
Flushing Hospital Medical Center CurrentSince Aug 15, 2013 Accepting new patients
TJH Medical Services, P.C. Surgery CurrentSince Jul 1, 1993 Accepting new patients
Jamaica Hospital CurrentSince Jul 1, 2019 Accepting new patients
Jamaica Hospital CurrentSince Jul 1, 2019 Accepting new patients
Jamaica Hospital Medical Center Past Accepting new patients
Jamaica Hospital Past Accepting new patients

Locations

14601 45th Ave
Flushing, NY 11355
Phone (718) 670-5562

11120 Merrick Blvd
Jamaica, NY 11433
Phone (718) 206-7510

11940 Metropolitan Ave
Kew Gardens, NY 11415
Phone (718) 849-0839

80 Marcus Dr
Melville, NY 11747
Phone (631) 391-7889

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: jchan2141@direct.medisys.org

Organizations & group practices 7

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.

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": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392336000000",
    "number": "1417918343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 MARCUS DR",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474230",
            "telephone_number": "631-391-7889",
            "fax_number": "631-454-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8906 135TH ST",
            "address_2": "SUITE 2T",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114182821",
            "telephone_number": "718-206-7110",
            "fax_number": "718-206-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JEFFREY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2014-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "206686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01755004",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.