Individual provider Active NPI

Meredith Chan, MD

  • Obstetrics & Gynecology Physician
  • Burnsville, MN
National Provider Identifier
1578907820
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
66027 Issued in MN
Practice address
14101 Fairview Dr
Burnsville, MN 55337
Phone
(952) 993-3282
NPI assigned
Apr 17, 2013
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 290063 NY
Obstetrics & Gynecology Physician 207V00000X 66027 MN Primary

Addresses

Primary practice location

14101 Fairview Dr
Burnsville, MN 55337

Mailing address

14101 Fairview Dr
Burnsville, MN 55337-4590
Phone (952) 993-3282

Other practice location 1

391 Myrtle Ave Ste 200
Albany, NY 12208-3835
Phone (518) 262-4942

Other practice location 2

391 Myrtle Ave Ste 200
Albany, NY 12208-3835
Phone (518) 262-4942

Other practice location 3

47 New Scotland Ave
Department of Obstetrics and Gynecology
Albany, NY 12208-3412
Phone (518) 262-3125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MN2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20170822000690 NY Practitioner - Obstetrics/Gynecology 4486926771 Reassigns benefits to 1 organization
I20190912002383 MN Practitioner - Obstetrics/Gynecology 4486926771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

14101 Fairview Dr
Suite 420
Burnsville, MN 55337-2539
Phone (952) 993-3282

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66027MNMDObstetrics & Gynecology Physician
290063NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic Obstetrics & Gynecology CurrentSince Sep 23, 2019 Accepting new patients
Albany Medical College CurrentSince Jul 1, 2017 Accepting new patients
Park Nicollet Clinic Obstetrics & Gynecology Current Accepting new patients
Albany Medical College Obstetrics & Gynecology CurrentSince Jun 1, 2019 Accepting new patients
Albany Medical College Obstetrics & Gynecology CurrentSince Jul 1, 2017 Accepting new patients
Albany Medical College Obstetrics & Gynecology Current Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

14101 Fairview Dr
Ste 420
Burnsville, MN 55337

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

16 New Scotland Ave
Albany, NY 12208
Phone (518) 262-4942

391 Myrtle Ave
Ste 200
Albany, NY 12208
Phone (518) 262-4942

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

391 Myrtle Ave
Albany, NY 12208
Phone (518) 262-5588

391 Myrtle Ave
Ste 2
Albany, NY 12208
Phone (518) 262-4942

Organizations & group practices 7

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.

Hospital & facility affiliations 6

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": "1366156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1578907820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14101 FAIRVIEW DR",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374590",
            "telephone_number": "952-993-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14101 FAIRVIEW DR",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "55337",
            "telephone_number": "952-993-3282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "391 Myrtle Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122083835",
            "country_code": "US",
            "telephone_number": "518-262-4942",
            "fax_number": "518-262-5291",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "391 Myrtle Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122083835",
            "country_code": "US",
            "telephone_number": "518-262-4942",
            "fax_number": "518-262-5291",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "47 New Scotland Ave",
            "address_2": "Department of Obstetrics and Gynecology",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122083412",
            "country_code": "US",
            "telephone_number": "518-262-3125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "MEREDITH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "290063",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "66027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

Verify at the official NPI Registry.