Active NPI
Calvin Chan, OD
- Optometrist
- Brooklyn, NY
National Provider Identifier
1659006120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 009619
- Practice address
- 2071 86TH St
Brooklyn, NY 11214-3203 - Phone
- (718) 355-9656
- NPI assigned
- Jul 19, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 009619 | NY | Primary |
Addresses
Primary practice location
2071 86TH St
Brooklyn, NY 11214-3203
Mailing address
2121 W 10TH St
Brooklyn, NY 11223-3525
Phone (646) 778-9889
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009619 | NY | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658188800000",
"number": "1659006120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2121 W 10TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112233525",
"telephone_number": "646-778-9889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2071 86TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112143203",
"telephone_number": "718-355-9656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "CALVIN",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-19",
"last_updated": "2022-07-19",
"certification_date": "2022-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "009619",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.