Individual provider Active NPI

Jennifer W Chan, STUDENT

  • Certified Registered Nurse Anesthetist
  • Burlington, MA
National Provider Identifier
1538874375
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN2295427 Issued in MA
Practice address
41 Mall Rd
Burlington, MA 01805-3800
Phone
(781) 744-8000
NPI assigned
Jan 17, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2295427 MA
Certified Registered Nurse Anesthetist 367500000X RN2295427 MA Primary

Addresses

Primary practice location

41 Mall Rd
Burlington, MA 01805-3800

Mailing address

PO Box 24520
New York, NY 10087-3720

Other practice location 1

140 Commonwealth Ave
Chestnut Hill, MA 02467-3800
Phone (617) 552-2756

Other practice location 2

243 Charles St
Boston, MA 02114-3002
Phone (617) 573-3380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250724002457 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062929193 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

243 Charles St
Boston, MA 02114-3002
Phone (617) 523-7900

29 Mall Rd
Burlington, MA 01805-0001

41 Mall Rd
Burlington, MA 01805-0001

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2295427MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts Eye and Ear Associates, Inc. CurrentSince Sep 2, 2025 Accepting new patients
Lahey Clinic, Inc. CurrentSince Jul 1, 2025 Accepting new patients
Lahey Clinic, Inc CurrentSince Jul 1, 2025 Accepting new patients

Locations

243 Charles St
Boston, MA 02114
Phone (617) 523-7900

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1673913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1538874375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24520",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018053800",
            "telephone_number": "781-744-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Commonwealth Ave",
            "address_purpose": "LOCATION",
            "city": "Chestnut Hill",
            "state": "MA",
            "postal_code": "024673800",
            "country_code": "US",
            "telephone_number": "617-552-2756",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "243 Charles St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021143002",
            "country_code": "US",
            "telephone_number": "617-573-3380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JENNIFER",
        "middle_name": "W",
        "credential": "STUDENT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-17",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2295427",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN2295427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.