Individual provider Active NPI

Michelle Chan

  • Infectious Disease Physician
  • Boston, MA
National Provider Identifier
1679004907
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
291788 Issued in MA
Practice address
110 Francis St Ste GB
Boston, MA 02215-5563
Phone
(617) 632-0760
NPI assigned
Mar 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 291788 MA Primary

Addresses

Primary practice location

110 Francis St Ste GB
Boston, MA 02215-5563

Mailing address

110 Francis St Ste GB
Boston, MA 02215-5563

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220707001188 MA Practitioner - Infectious Disease 7315217130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 754-8612

Hospital & facility affiliations

  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086
  • Beth Israel Deaconess Hospital - Needham Hospital, Needham, MA, CCN 220083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jul 1, 2022 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jul 1, 2022 Accepting new patients

Locations

110 Francis St
Ste Gb
Boston, MA 02215
Phone (617) 632-0760

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

Organizations & group practices 2

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": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1679004907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 FRANCIS ST STE GB",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 FRANCIS ST STE GB",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155563",
            "telephone_number": "617-632-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MA",
            "license": "291788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.