Charmaine San Yee Chan, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS013824 Issued in PA

Practice address

4190 City Ave
Suite 100
Philadelphia, PA 19131-1626

Phone

(215) 871-6380

Fax

(215) 871-6381

NPI assigned

Sep 22, 2007

Last updated

Oct 5, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Philadelphia College of Osteopathic Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trinity Health Mid-Atlantic Medical GroupGroup PAC ID 7416861885, 350 clinicians

St Mary Medical CenterGroup PAC ID 4688588064, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Nazareth Hospital Hospital, Philadelphia, PA, CCN 390204

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cchan84862@direct.trinity-health.org
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• St Mary Medical Center

  dba St. Mary Family Medicine Bensalem

  • Family Medicine Physician
  • Bensalem, PA
  • NPI 1083622286

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Trinity Health Mid-Atlantic Medical Group

  dba THMA MG Surgical Associates Holme

  • Surgery Physician
  • Langhorne, PA
  • NPI 1972982361

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Nazareth Hospital

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1124023015

  Multi-Specialty

  Medicare reassignment NPD
• Nazareth Hospital

  • Ambulatory Surgical Clinic/Center
  • Philadelphia, PA
  • NPI 1215064704
  NPD
• St Mary Medical Center

  dba St. Clare Pharmacy

  • Community/Retail Pharmacy
  • Langhorne, PA
  • NPI 1750683504
  NPD
• Trinity Health Mid-Atlantic Medical Group

  dba THMA MG Trauma Service Langhorne

  • Trauma Surgery Physician
  • Langhorne, PA
  • NPI 1093771271

  Multi-Specialty

  NPD
• Trinity Health Mid-Atlantic Medical Group

  • Physical Medicine & Rehabilitation Physician
  • Philadelphia, PA
  • NPI 1639039175

  Multi-Specialty

  NPD
• Philadelphia College of Osteopathic Medicine

  • Clinical Psychologist
  • Philadelphia, PA
  • NPI 1316230220

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1190419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1467648519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 UNIVERSITY DR STE 106",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401873",
            "telephone_number": "610-772-6889",
            "fax_number": "313-887-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 CITY AVE",
            "address_2": "SUITE 100",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311626",
            "telephone_number": "215-871-6380",
            "fax_number": "215-871-6381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2630 Holme Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191523004",
            "country_code": "US",
            "telephone_number": "267-957-7027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "CHARMAINE",
        "middle_name": "SAN YEE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-22",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS013824",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "OS013824",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wichana Chamroonrat, MD
• Dalila Chamseddine, DMD
• Ada Chan, PHD
• Alexander C Chan, RPH
• Brian Chan
• Cheuk Ho Chan, PT, DPT
• Christine Chan, M.D.
• Donna Chan
• Elena Michelle Chan
• Emily Rose Chan, MD

• Family Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; 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.