Individual provider Active NPI

Sue Shu-Kwan Chan, M.D.

  • Pediatrics Physician
  • Oakland, CA
National Provider Identifier
1497825988
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
C35751 Issued in CA
Practice address
818 Webster St
Oakland, CA 94607-4220
Phone
(510) 986-6830
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X C35751 CA Primary

Addresses

Primary practice location

818 Webster St
Oakland, CA 94607-4220

Mailing address

818 Webster St
Oakland, CA 94607-4220
Phone (510) 986-6830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20100917001107 CA Practitioner - Pediatric Medicine 2264557958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Ohio State University College of Medicine, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Asian Health ServicesGroup PAC ID 0244271021, 93 clinicians

Practice addresses (Care Compare)

818 Webster St
Oakland, CA 94607-4220
Phone (510) 986-6800

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Asian Health Services CurrentSince Jun 8, 2010 Accepting new patients
Asian Health Services CurrentSince Jun 8, 2010 Accepting new patients
Asian Health Services Past Accepting new patients
Children'S Hospital & Research Center at Oakland Past Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients
Alta Bates Summit Medical Center Past Accepting new patients

Locations

818 Webster St
Oakland, CA 94607
Phone (510) 986-6800

101 8th St
Ste 100
Oakland, CA 94607
Phone (510) 735-3100

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497825988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 WEBSTER ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946074220",
            "telephone_number": "510-986-6830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 WEBSTER ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946074220",
            "telephone_number": "510-986-6830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "SUE SHU-KWAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C35751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.