Individual provider Active NPI

Wien Chan, MD

  • Family Medicine Physician
  • Sarasota, FL
National Provider Identifier
1427616036
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
154566 Issued in FL
Practice address
5937 Beneva Rd
Sarasota, FL 34238-2504
Phone
(941) 918-2011
Fax
(941) 210-3610
NPI assigned
May 30, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 154566 FL Primary

Addresses

Primary practice location

5937 Beneva Rd
Sarasota, FL 34238-2504

Mailing address

5937 Beneva Rd
Sarasota, FL 34238-2504
Phone (941) 918-2011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220831002831 FL Practitioner - Family Practice 5890179436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunshine Medical Center LLCGroup PAC ID 2163454406, 4 clinicians

Practice addresses (Care Compare)

5937 Beneva Rd
Sarasota, FL 34238-2504
Phone (941) 918-2011

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
154566FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sunshine Medical Center LLC CurrentSince Aug 1, 2022 Accepting new patients

Locations

5937 Beneva Rd
Sarasota, FL 34238
Phone (941) 918-2011

Interoperability endpoints

  • Direct secure messaging: wien.chan.1@12915.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1427616036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5937 BENEVA RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342382504",
            "telephone_number": "941-918-2011",
            "fax_number": "941-210-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5937 BENEVA RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342382504",
            "telephone_number": "941-918-2011",
            "fax_number": "941-210-3610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "WIEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-30",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "154566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.