Active NPI
Jim Chan
- Pharmacist
- Rego Park, NY
National Provider Identifier
1669965331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 064048
- Practice address
- 9890A Queens Blvd
Rego Park, NY 11374-4354 - Phone
- (718) 459-1500
- NPI assigned
- Jun 7, 2018
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 064048 | NY | Primary |
Addresses
Primary practice location
9890A Queens Blvd
Rego Park, NY 11374-4354
Mailing address
9890A Queens Blvd
Rego Park, NY 11374-4354
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 064048 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Levin's Drugs Inc. | Pharmacist | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pharmacist
- Rego Park, NY
- NPI 1598806580
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622073600000",
"number": "1669965331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9890A QUEENS BLVD",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113744354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9890A QUEENS BLVD",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113744354",
"telephone_number": "718-459-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "JIM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-07",
"last_updated": "2021-05-27",
"certification_date": "2021-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "064048",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rego Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.