Individual provider Active NPI

Angie Chan, FNP

  • Family Nurse Practitioner
  • New Hyde Park, NY
National Provider Identifier
1538760988
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
345511 Issued in NY
Practice address
1991 Marcus Ave FL 2
New Hyde Park, NY 11042-2057
Phone
(516) 354-1600
Fax
(516) 941-4673
NPI assigned
Nov 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 345511 NY Primary

Addresses

Primary practice location

1991 Marcus Ave FL 2
New Hyde Park, NY 11042-2057

Mailing address

55 Water St FL 2
New York, NY 10041-0010
Phone (646) 680-2888

Other practice location 1

70 Charles Lindbergh Blvd Ste 100
Uniondale, NY 11553-3634
Phone (516) 483-2020

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250211000227 NY Practitioner - Nurse Practitioner 9830629500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantagecare Physicians PCGroup PAC ID 2365735008, 307 clinicians

Practice addresses (Care Compare)

1991 Marcus Ave
FL 2
New Hyde Park, NY 11042-2057
Phone (516) 354-1600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
345511NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advantagecare Physicians PC CurrentSince Mar 24, 2025 Accepting new patients
Advantagecare Physicians PC CurrentSince Mar 24, 2025 Accepting new patients
Cohen Medical Practice PC PastSince Aug 1, 2022 Accepting new patients

Locations

233 Nostrand Ave
Brooklyn, NY 11205
Phone (646) 680-1595

1991 Marcus Ave
Fl 2
New Hyde Park, NY 11042
Phone (516) 354-1600

55 Water St
Fl 2
New York, NY 10041

70 Charles Lindbergh Blvd
Ste 100
Uniondale, NY 11553
Phone (516) 483-2020

70 Charles Lindbergh Blvd
Ste 1
Uniondale, NY 11553
Phone (516) 483-2020

Networks

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

Interoperability endpoints

  • FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4
  • Direct secure messaging: achan55069@direct.acpny.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1538760988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATER ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410010",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 MARCUS AVE FL 2",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110422057",
            "telephone_number": "516-354-1600",
            "fax_number": "516-941-4673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 Charles Lindbergh Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Uniondale",
            "state": "NY",
            "postal_code": "115533634",
            "country_code": "US",
            "telephone_number": "516-483-2020",
            "fax_number": "516-941-3892",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "ANGIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-03",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "345511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.