Addison Chan

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

OS022272 Issued in PA

Practice address

1700 Coffee Rd
Emergency Department
Modesto, CA 95355-2803

Phone

(209) 526-4500

NPI assigned

Dec 14, 2009

Last updated

Feb 13, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in CA, ND, TX, FL4 enrollments

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 4

Specialty

Emergency Medicine

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Texas Emergency Physicians PLLCGroup PAC ID 8527420306, 195 clinicians

Emergency Medicine Services of TX, PLLCGroup PAC ID 3375909351, 374 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801
• Valley Regional Medical Center Hospital, Brownsville, TX, CCN 450662

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: achan309299@christushealth.direct-ci.net

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.

• Emergency Medicine Services of TX, PLLC

  • Emergency Medicine Physician
  • San Antonio, TX
  • NPI 1245938729
  Medicare reassignment Care Compare group NPD
• Northeast Texas Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Longview, TX
  • NPI 1114607611
  Medicare reassignment Care Compare group NPD
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment NPD
• Acute Care Specialists

  • Emergency Medicine Physician
  • Longview, TX
  • NPI 1740655273
  Medicare reassignment NPD
• Emergency Medical Associates of Tampa Bay, LLC

  dba Excelis Medical Associates

  • Emergency Medicine Physician
  • Tampa, FL
  • NPI 1023397817
  Medicare reassignment NPD
• Integrative Emergency Services Physician Group-Houston PLLC

  dba IES Houston

  • Emergency Medicine Physician
  • Pasadena, TX
  • NPI 1801458708
  Medicare reassignment NPD
• Observation Medical Group LLC

  • Emergency Medicine Physician
  • Tampa, FL
  • NPI 1952763682
  Medicare reassignment NPD
• Sound Physicians Emergency Medicine of Texas PLLC

  • Emergency Medicine Physician
  • Killeen, TX
  • NPI 1518475557
  Medicare reassignment NPD
• St Joseph's Hospital and Health Center

  dba CHI St Alexius Health Dickinson Medical Clinic

  • Clinic/Center
  • Dickinson, ND
  • NPI 1730464108
  Medicare reassignment NPD
• St. Joseph's Hospital and Health Center

  dba CHI St Alexius Health Dickinson

  • Critical Access Hospital
  • Dickinson, ND
  • NPI 1992947956
  Medicare reassignment NPD
• W4P LLC

  dba Hernando County Emergency Physicians

  • Emergency Medicine Physician
  • Spring Hill, FL
  • NPI 1689116618
  Medicare reassignment NPD
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • Modesto, CA
  • NPI 1396044491
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christus Health Ark-la-Tex

  dba Christus St. Michael Health System

  • General Practice Physician
  • Texarkana, TX
  • NPI 1184623266

  Hospital

  Care Compare affiliation
• Christus Health Ark-la-Tex

  dba CHRISTUS St. Michael Health System

  • General Acute Care Hospital
  • Texarkana, TX
  • NPI 1295736734
  Care Compare affiliation
• Columbia Valley Healthcare System, L.P.

  dba Valley Regional Medical Center

  • General Acute Care Hospital
  • Brownsville, TX
  • NPI 1043267701
  Care Compare affiliation

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

{
    "created_epoch": "1260748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1568791994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4012 WILD POPPY CT",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953568793",
            "telephone_number": "831-239-8371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 COFFEE RD",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552803",
            "telephone_number": "209-526-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 S Cedar Crest Blvd",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181036202",
            "country_code": "US",
            "telephone_number": "484-862-3232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "ADDISON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-14",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "R7410",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A11051",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS022272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1200 S Cedar Crest Blvd",
            "city": "Allentown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "181036202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1200 S Cedar Crest Blvd",
            "city": "Allentown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "181036202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Srikanth Challagundla, M.D
• Breanna Quinette Chalupnik
• Pharami Cham
• Sadie-Marie Chambers
• Ronald Lynn Champion, D.D.S.
• Christina Chan, M.D.
• Christine Yaju Chan, M.D.
• Jackie TSZ-Kit Chan, M.D.
• Jessica Chan, PA-C
• John C Chan, M.D.

• Emergency Medicine Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.