Active NPI
Katherine Chan, PA-C
- Physician Assistant
- Newark, DE
National Provider Identifier
1659844421
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- C5-0001278
- Practice address
- 4755 Ogletown Stanton Rd Ste 5A43
Newark, DE 19718-2200 - Phone
- (302) 623-0188
- NPI assigned
- Jan 4, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | C5-0001278 | DE | Primary |
Addresses
Primary practice location
4755 Ogletown Stanton Rd Ste 5A43
Newark, DE 19718-2200
Mailing address
200 Hygeia Dr Ste 2300
Newark, DE 19713-2049
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C5-0001278 | DE | MD | Physician Assistant |
Interoperability endpoints
- kchan88322@tuftsmedicine.direct-ci.com
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546560000000",
"number": "1659844421",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 HYGEIA DR STE 2300",
"city": "NEWARK",
"state": "DE",
"postal_code": "197132049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4755 OGLETOWN STANTON RD STE 5A43",
"city": "NEWARK",
"state": "DE",
"postal_code": "197182200",
"telephone_number": "302-623-0188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "KATHERINE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-04",
"last_updated": "2019-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "DE",
"license": "C5-0001278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Newark, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.