Individual provider Active NPI

Lawrence Andrew Lim Chan, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Brooklyn, NY
National Provider Identifier
1487003448
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
319265 Issued in NY
Practice address
450 Clarkson Ave # 30
Brooklyn, NY 11203-2012
Phone
(718) 613-8653
Fax
(718) 270-3440
NPI assigned
Jun 9, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 319265 NY Primary
Physical Medicine & Rehabilitation Physician 208100000X 25MB11467300 NJ

Addresses

Primary practice location

450 Clarkson Ave # 30
Brooklyn, NY 11203-2012

Mailing address

450 Clarkson Ave # 30
Brooklyn, NY 11203-2012
Phone (718) 270-2055

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
I20221213003062 NY Practitioner - Physical Medicine and Rehabilitation 2163718156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physicians of Brooklyn, Inc.Group PAC ID 0749192284, 174 clinicians

Practice addresses (Care Compare)

450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (718) 270-1546

Hospital & facility affiliations

  • Suny/Downstate University Hospital of Brooklyn Hospital, Brooklyn, NY, CCN 330350
  • Suny Downstate Medical Center Inpatient rehabilitation facility, Brooklyn, NY, CCN 33T350

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB11467300NJMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians of Brooklyn, Inc. Physical Medicine & Rehabilitation CurrentSince Sep 2, 2022 Accepting new patients
University Physicians of Brooklyn, Inc. CurrentSince Sep 2, 2022 Accepting new patients
University Physicians of Brooklyn, Inc. Current Accepting new patients
University Physicians of Brooklyn, Inc PastSince Nov 1, 2022 Accepting new patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers Past Accepting new patients

Locations

450 Clarkson Ave
#30
Brooklyn, NY 11203
Phone (718) 270-2179

450 Clarkson Ave
#80
Brooklyn, NY 11203
Phone (718) 613-8481

450 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 270-1603

760 Parkside Ave
Brooklyn, NY 11226
Phone (917) 751-9093

Networks

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

Interoperability endpoints

  • Direct secure messaging: lawrence.chan.1@438.direct.athenahealth.com

Organizations & group practices 5

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 2

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": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1487003448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE # 30",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-270-2055",
            "fax_number": "718-270-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE # 30",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-613-8653",
            "fax_number": "718-270-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "LAWRENCE ANDREW",
        "middle_name": "LIM",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-09",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "319265",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "25MB11467300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.