Individual provider Active NPI

Anna Chan, M.D.

  • Family Medicine Physician
  • Flushing, NY
National Provider Identifier
1477851103
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
265458 Issued in NY
Practice address
14105 Cherry Ave
Unit 1E
Flushing, NY 11355-3291
Phone
(718) 358-0038
Fax
(718) 358-0043
NPI assigned
Mar 3, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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 265458 NY Primary

Addresses

Primary practice location

14105 Cherry Ave
Unit 1E
Flushing, NY 11355-3291

Mailing address

14105 Cherry Ave
Unit 1E
Flushing, NY 11355-3291
Phone (718) 358-0038

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
I20130111000415 NY Practitioner - Family Practice 2466605951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14105 Cherry Ave
Apt 1E
Flushing, NY 11355-3292
Phone (718) 358-0038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
265458NYMDFamily Medicine Physician

Networks

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1299110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1477851103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14105 CHERRY AVE",
            "address_2": "UNIT 1E",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553291",
            "telephone_number": "718-358-0038",
            "fax_number": "718-358-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14105 CHERRY AVE",
            "address_2": "UNIT 1E",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553291",
            "telephone_number": "718-358-0038",
            "fax_number": "718-358-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "ANNA",
        "name_prefix": "Miss",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-03",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "265458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.