Pennapa S Chan, MD

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

41501-020 Issued in WI

Practice address

451 Junction Rd
Madison, WI 53717-2656

Phone

(608) 263-5010

Fax

(608) 265-7519

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Endocrinology

Education

Southern Illinois University School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

University of Wisconsin Medical Foundation IncGroup PAC ID 6608785464, 2,537 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Wi Hospitals & Clinics Authority Hospital, Madison, WI, CCN 520098
• Unitypoint Health - Meriter Hospital, Madison, WI, CCN 520089

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pchan6028886@direct.uwhealth.org
• Direct secure messaging: pchan568248@direct.peacehealth.org

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.

• University of Wisconsin Medical Foundation, Inc

  • Multi-Specialty Clinic/Center
  • Middleton, WI
  • NPI 1598784555
  Medicare reassignment Care Compare group NPD
• Aurora Medical Group, Inc.

  • Certified Registered Nurse Anesthetist
  • Milwaukee, WI
  • NPI 1427271378
  Medicare reassignment
• University of Wisconsin Medical Foundation, Inc

  • Health Educator
  • Madison, WI
  • NPI 1487414082
  NPD
• University of Wisconsin Medical Foundation Inc

  • Durable Medical Equipment & Medical Supplies
  • Cross Plains, WI
  • NPI 1174583363
  NPD (past)
• Tri Cities Community Health

  • Federally Qualified Health Center (FQHC)
  • Pasco, WA
  • NPI 1659995504
  NPD (past)

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

• Meriter Hospital, Inc.

  • Rehabilitation Clinic/Center
  • Madison, WI
  • NPI 1073672556

  Hospital

  Care Compare affiliation
• Meriter Hospital, Inc.

  • General Acute Care Hospital
  • Madison, WI
  • NPI 1114920048
  Care Compare affiliation
• University of Wisconsin Hospitals and Clinics Authority

  • General Acute Care Hospital
  • Madison, WI
  • NPI 1922043744
  Care Compare affiliation

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1457405128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 JUNCTION RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537172656",
            "telephone_number": "608-263-5010",
            "fax_number": "608-265-7519"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3377 Riverbend Dr",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974778803",
            "country_code": "US",
            "telephone_number": "458-205-6543",
            "fax_number": "458-205-6492",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1313 Fish Hatchery Rd",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537151911",
            "country_code": "US",
            "telephone_number": "608-252-8000",
            "fax_number": "608-252-8268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "PENNAPA",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "OR",
            "license": "MD212597",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "WI",
            "license": "41501-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34390100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH INSURANCE",
            "identifier": "60653",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pchan6028886@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "451 Junction Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537172656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Teresa Maria Chamorro, PSYD
• Andrew W Champion, MA, LPC
• Brian Yang Chan, MD
• Dorothy Chan, MD
• Fountane Chan, MD
• Krisada Chanbusarakum, M.D.
• Puangpetch Chanbusarakum
• Luke William Chandler, C-AA
• Medhavani Dhruv Chandra, MD
• Suresh R Chandra, MD

• Endocrinology, Diabetes & Metabolism Physician in Madison, WI
• Providers in Madison, WI by specialty
• Endocrinology, Diabetes & Metabolism Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.