Active NPI
John R Chan, MD
- Infectious Disease Physician
- Bronx, NY
National Provider Identifier
1487739256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- 149278
- Practice address
- MMC - Dept. of Medicine
111 E. 210TH Street
Bronx, NY 10467 - Phone
- (718) 920-3831
- NPI assigned
- Oct 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | 149278 | NY | Primary |
Addresses
Primary practice location
MMC - Dept. of Medicine
111 E. 210TH Street
Bronx, NY 10467
Mailing address
35 Buena Vista Dr
Hastings on Hudson, NY 10706-1103
Phone (718) 920-3831
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149278 | NY | MD | Infectious Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487739256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 BUENA VISTA DR",
"city": "HASTINGS ON HUDSON",
"state": "NY",
"postal_code": "107061103",
"telephone_number": "718-920-3831",
"fax_number": "718-430-2968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MMC - DEPT. OF MEDICINE",
"address_2": "111 E. 210TH STREET",
"city": "BRONX",
"state": "NY",
"postal_code": "10467",
"telephone_number": "718-920-3831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "JOHN",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "NY",
"license": "149278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.