Trevor Chan, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

59870 Issued in MN

Practice address

800 Medical Center Dr
Fairmont, MN 56031-4575

Phone

(507) 238-8100

NPI assigned

Jun 11, 2013

Last updated

Sep 17, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Family Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mayo Clinic Health System-FairmontGroup PAC ID 4981694981, 156 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mayo Clinic Health System - Fairmont Hospital, Fairmont, MN, CCN 240166
• Mayo Clinic Health System - Mankato Hospital, Mankato, MN, CCN 240093

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tchan87605@ehrdirect.mayoclinicmsg.org

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.

• Mayo Clinic Health System-Fairmont

  • Multi-Specialty Clinic/Center
  • Fairmont, MN
  • NPI 1366410862
  Medicare reassignment Care Compare group NPD
• Mayo Clinic Health System-Fairmont

  • General Acute Care Hospital
  • Fairmont, MN
  • NPI 1821066499
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mayo Clinic Health System-Fairmont

  • General Acute Care Hospital
  • Fairmont, MN
  • NPI 1821066499
  Care Compare affiliation
• Mayo Clinic Health System-Southwest Minnesota Region

  dba Mayo Clinic Health System - Mankato

  • General Acute Care Hospital
  • Mankato, MN
  • NPI 1154302487
  Care Compare affiliation

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1447698550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MEDICAL CENTER DR",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314575",
            "telephone_number": "507-238-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MEDICAL CENTER DR",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314575",
            "telephone_number": "507-238-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "TREVOR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-11",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "59870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tchan87605@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "800 Medical Center Dr",
            "city": "Fairmont",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560314575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carlson Dental Office PA
• Fredrick D Carlson, DDS
• Paul F Carlson, DDS
• Center for Anesthesia Services, LLC
• Ingrid Chan, M.D.
• Christopher L. Olsen, DDS PLLC (Larson and Olsen Dental PA)
• Michael Daniel Clancey, D.C.
• Zephanie Cole, D.C.
• John Coniaris, MD
• Cornerstone Clinic , PSC

• Family Medicine Physician in Fairmont, MN
• Providers in Fairmont, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; 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.