Individual provider Active NPI

Wayne Elroy Chan, NP

  • Adult Health Nurse Practitioner
  • Schenectady, NY
National Provider Identifier
1659900546
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
309580 Issued in NY
Practice address
504 State St
Schenectady, NY 12305-2414
Phone
(518) 525-5634
NPI assigned
Apr 3, 2020
Last updated
May 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 309580 NY Primary

Addresses

Primary practice location

504 State St
Schenectady, NY 12305-2414

Mailing address

PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634

Other practice location 1

2215 Burdett Ave
Troy, NY 12180-2466
Phone (518) 270-3008

Other practice location 2

315 S Manning Blvd
Albany, NY 12208-1707
Phone (518) 525-5634

Other practice location 3

1270 Belmont Ave
Schenectady, NY 12308-2104
Phone (518) 382-4500

Other practice location 4

433 River St Ste 3000
Troy, NY 12180-2250
Phone (518) 279-5700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200514002620 NY Practitioner - Nurse Practitioner 4789015363 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Visiting Services, LLCGroup PAC ID 2961824842, 31 clinicians

Practice addresses (Care Compare)

200 Washington Ave Ext
Albany, NY 12203-5335
Phone (518) 428-8610

240 N Main St
Spring Valley, NY 10977-4020
Phone (845) 241-9724

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Visiting Services, LLC CurrentSince Jul 1, 2023 Accepting new patients
Upstate Wellness and Aesthetic Services Current Accepting new patients
St. Peter's Health Partners Medical Associates, P.C. CurrentSince May 1, 2020 Accepting new patients
Brookview Medical Associates, PLLC CurrentSince Sep 1, 2022 Accepting new patients
Visiting Medical PC CurrentSince Dec 1, 2025 Accepting new patients
St. Peter's Hospital of the City of Albany Past Accepting new patients

Locations

200 Washington Avenue Ext
Albany, NY 12203
Phone (518) 456-2000

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

80 Orville Dr
Ste 100
Bohemia, NY 11716
Phone (516) 308-6610

1270 Belmont Ave
Schenectady, NY 12308
Phone (518) 382-4500

240 N Main St
Spring Valley, NY 10977
Phone (845) 374-0410

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

2902 Upper Tibbits Ave
Troy, NY 12180
Phone (518) 273-2040

433 River St
Ste 3000
Troy, NY 12180
Phone (518) 274-6200

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Networks

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

Interoperability endpoints

  • Direct secure messaging: payer.credentialing@sphp.com

Organizations & group practices 6

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": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1659900546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "518-525-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 STATE ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123052414",
            "telephone_number": "518-525-5634"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2215 Burdett Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802466",
            "country_code": "US",
            "telephone_number": "518-270-3008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 S Manning Blvd",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122081707",
            "country_code": "US",
            "telephone_number": "518-525-5634",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1270 Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Schenectady",
            "state": "NY",
            "postal_code": "123082104",
            "country_code": "US",
            "telephone_number": "518-382-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "433 River St Ste 3000",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802250",
            "country_code": "US",
            "telephone_number": "518-279-5700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "WAYNE",
        "middle_name": "ELROY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-03",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "309580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP- Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "315 S Manning Blvd",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122081707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

Verify at the official NPI Registry.