Susana Chan, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODTG00518 Issued in RI

Practice address

387 Waterman Ave
East Providence, RI 02914-2618

Phone

(401) 453-5800

Fax

(401) 271-6867

NPI assigned

Feb 21, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in RI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

State University of New York - State College Optometry, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Susana Chan, OD, P.C.

  • Optometrist
  • East Providence, RI
  • NPI 1376235069
  Medicare reassignment NPD Authorized official
• 20/20 Vision Care, Inc.

  • Optometrist
  • Bristol, RI
  • NPI 1700991932
  Medicare reassignment
• Harry Robert Maximilan Koster, MD PC

  • Ophthalmology Physician
  • Richmond Hill, NY
  • NPI 1932211786
  NPD (past)

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1619002854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "387 WATERMAN AVE",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029142618",
            "telephone_number": "401-453-5800",
            "fax_number": "401-271-6867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "387 WATERMAN AVE",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029142618",
            "telephone_number": "401-453-5800",
            "fax_number": "401-271-6867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "SUSANA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "RI",
            "license": "ODTG00518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "23-77354",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NIEGHBORHOOD HEALTH PLAN",
            "identifier": "32425",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "414188",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9082077",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRUE CROSS",
            "identifier": "0000032701",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Castle, PT
• Rachel Joyce Caswell, OTR/L
• Meredith Rose Cavanagh, PA-C
• Jennifer Kay Chace, MSAPRN
• Megan E Chakey
• Allison Mary Charleson
• Alexis C Charves, CRNA
• Kelly Taber Chasse, MSW
• Myra A Chaudary, D.O.
• Pauley Chea, M.D.

• Optometrist in East Providence, RI
• Providers in East Providence, RI by specialty
• Optometrist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.