Kimberly Chan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

600 East 233 Street
General Surgery, 4TH Floor
Bronx, NY 10466

Phone

(347) 628-2682

NPI assigned

Feb 25, 2020

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

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

Interoperability endpoints

• Direct secure messaging: kchan2@montefioredirect.com

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.

• Medalliance Medical Health Services Inc

  • Clinic/Center
  • Bronx, NY
  • NPI 1558356741
  Medicare reassignment
• RJ Medical & Urgent Care, PLLC

  • Urgent Care Clinic/Center
  • Brooklyn, NY
  • NPI 1346632262
  Medicare reassignment
• 464 Bay Ridge Medical PLLC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1912568981
  NPD (past)

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

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662249600000",
    "number": "1669006045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 EAST 233RD STREET 4TH FLOOR",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10466",
            "telephone_number": "347-628-2682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 EAST 233 STREET",
            "address_2": "GENERAL SURGERY, 4TH FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10466",
            "telephone_number": "347-628-2682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 Bowery Street 7th Fl",
            "address_purpose": "LOCATION",
            "city": "New york",
            "state": "NY",
            "postal_code": "10002",
            "country_code": "US",
            "telephone_number": "347-628-2682",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "464 Bay Ridge Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112205906",
            "country_code": "US",
            "telephone_number": "347-628-2682",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "108 Beverley Rd",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112183914",
            "country_code": "US",
            "telephone_number": "718-218-5551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "KIMBERLY",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-25",
        "last_updated": "2022-09-04",
        "certification_date": "2022-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joey Chan, PT, DPT
• John R Chan, MD
• Jorge Chua Chan, MD
• Judy P. Chan, PA
• Kang Ning Chan, MD
• Lauren L Chan, DPM
• Lily Chan, OTR/L
• Margi Chan, DMD
• Melissa Yeekay Chan, MD
• Michele G Chan, PHD

• Physician Assistant in Bronx, NY
• Providers in Bronx, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2022; 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.

Verify at the official NPI Registry.