Ian Chan MD PC

Primary specialty

Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X

License

249201 Issued in NY

Legal business name

IAN CHAN MD PC

Practice address

3808 Union St Ste 5D
Flushing, NY 11354

Phone

(631) 213-1668

Fax

(718) 509-6993

NPI assigned

Aug 1, 2013

Organization subpart

No

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

Authorized official

Name

Ian Chan, MDNPI 1942406756

Title

President

Phone

(917) 238-7875

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Ian Chan MD PC

  • Ophthalmologic Surgery Clinic/Center
  • New York, NY
  • NPI 1083058432

  O20130508000038

  Same enrollment
• Ian Chan MD PC

  • Ophthalmology Physician
  • Brooklyn, NY
  • NPI 1710546270

  O20130508000038

  Same enrollment

Tax ID family

Ian Chan MD PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Ian Chan MD PC

  • Ophthalmologic Surgery Clinic/Center
  • New York, NY
  • NPI 1083058432
  NPD tax ID
• Ian Chan MD PC

  • Ophthalmology Physician
  • Brooklyn, NY
  • NPI 1710546270
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ian Hing-Yeung Chan, MD

  • Ophthalmology Physician
  • New York, NY
  • NPI 1942406756
  NPD (past) Authorized official

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

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535932800000",
    "number": "1568894590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3808 UNION ST STE 5D",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545672",
            "telephone_number": "631-213-1668",
            "fax_number": "718-509-6993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3808 UNION ST STE 5D",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11354",
            "telephone_number": "631-213-1668",
            "fax_number": "718-509-6993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IAN CHAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-01",
        "last_updated": "2018-09-03",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "IAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-238-7875",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "NY",
            "license": "249201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03580976",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ilana Ibragimov, FNP
• Regina Ibragimov
• Shiran Ibragimov, PA
• Barbara Ibragimova, NP
• Berta Ibragimova, MS. SPED

• Ophthalmologic Surgery Clinic/Center in Flushing, NY
• Providers in Flushing, NY by specialty
• Ophthalmologic Surgery Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.