Individual provider Active NPI

Phillip Ming-Ming Chin

  • Anesthesiology Physician
  • Valhalla, NY
National Provider Identifier
1659833879
Registry record updated Dec 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
322399-01 Issued in NY
Practice address
100 Woods Rd
Valhalla, NY 10595-1530
Phone
(914) 493-7000
NPI assigned
Apr 5, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 322399-01 NY Primary

Addresses

Primary practice location

100 Woods Rd
Valhalla, NY 10595-1530

Mailing address

66 Law St
Valley Stream, NY 11580-1018
Phone (347) 761-1674

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20231009001549 NY Practitioner - Anesthesiology 8628423852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
New York College of Osteo Medicine of New York Institute of Technology, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore - Lij Anesthesiology, PCGroup PAC ID 1153602453, 990 clinicians

Practice addresses (Care Compare)

301 E Main St
Bay Shore, NY 11706-8408
Phone (914) 666-8866

Hospital & facility affiliations

  • NS/Lij HS Southside Hospital Hospital, Bay Shore, NY, CCN 330043

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
322399-01NYMDAnesthesiology Physician

Practice roles (1 of 5)

OrganizationSpecialtyStatusNew patients
North Shore - Lij Anesthesiology, PC Anesthesiology CurrentSince Aug 15, 2023 Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

27005 76th Ave
North New Hyde Pk, NY 11040

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733616000000",
    "number": "1659833879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 LAW ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115801018",
            "telephone_number": "347-761-1674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WOODS RD",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951530",
            "telephone_number": "914-493-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN",
        "first_name": "PHILLIP",
        "middle_name": "MING-MING",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-05",
        "last_updated": "2024-12-08",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "322399-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

Verify at the official NPI Registry.