Individual provider Active NPI

Samuel Yan-Ho Chan, M.D.

  • Specialist
  • Denver, CO
National Provider Identifier
1508830811
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
33675 Issued in CO
Practice address
2490 W 26TH Ave Ste 10a
Denver, CO 80211-5300
Phone
(303) 331-6744
Fax
(303) 337-6839
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 33675 CO Primary

Addresses

Primary practice location

2490 W 26TH Ave Ste 10a
Denver, CO 80211-5300

Mailing address

2490 W 26TH Ave
Ste 10a
Denver, CO 80211-5300
Phone (303) 331-6744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20050617000650 CO Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 2668424300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
University of Washington School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mile High Sports and Rehabilitation Medicine, PCGroup PAC ID 3779508551, 6 clinicians

Practice addresses (Care Compare)

2490 W 26TH Ave
Denver, CO 80211-5300
Phone (303) 331-6744

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33675COMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Mile High Sports and Rehabilitation Medicine, PC CurrentSince Jul 1, 2005 Accepting new patients
Mile High Sports and Rehabilitation Medicine, P.C. Past Accepting new patients
Mile High Sports and Rehabilitation Medicine, PC Past Accepting new patients
Mile High Sports and Rehabilitation Medicine, PC Past Accepting new patients
Park Avenue Surgery Center LLC PastSince Aug 1, 2012 Accepting new patients
Catherine D Carretero MD PC PastSince May 13, 2008 Accepting new patients

Locations

2150 W 29th Ave
Ste 600
Denver, CO 80211
Phone (303) 331-6744

2490 W 26th Ave
Ste 10A
Denver, CO 80211
Phone (303) 331-6744

4545 E 9th Ave
Ste 440
Denver, CO 80220
Phone (303) 320-1111

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1508830811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 W 26TH AVE",
            "address_2": "STE 10A",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802115300",
            "telephone_number": "303-331-6744",
            "fax_number": "303-337-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 W 26TH AVE STE 10A",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802115300",
            "telephone_number": "303-331-6744",
            "fax_number": "303-337-6839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "SAMUEL",
        "middle_name": "YAN-HO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "33675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.