NPIMap

Individual provider Active NPI

Cesar A. Chan Jr., M.D.

  • Gastroenterology Physician
  • Panama City, FL
National Provider Identifier
1679519797
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME162947 Issued in FL
Practice address
204 E 19TH St
Panama City, FL 32405-4707
Phone
(850) 763-5409
Fax
(850) 763-4072
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 42817 WI
Gastroenterology Physician 207RG0100X ME162947 FL Primary

Addresses

Primary practice location

204 E 19TH St
Panama City, FL 32405-4707

Mailing address

204 E 19TH St
Panama City, FL 32405-4707
Phone (850) 763-5409

Other identifiers 2

IdentifierTypeStateIssuer
34034200MedicaidWI
P00705300OtherWIRR MEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cchan577@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050117000031 WI Practitioner - GastroenterologyPractitioner - Internal Medicine 1951350099
I20231107002054 FL Practitioner - Gastroenterology 1951350099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Digestive Diseases Center of Florida PLLCGroup PAC ID 0345227328, 15 clinicians

Practice addresses (Care Compare)

204 E 19TH St
Panama City, FL 32405-4707
Phone (850) 763-5409

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy212
Upper gastrointestinal (GI) endoscopy for acid reflux285

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME162947FLMDGastroenterology Physician
42817WIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Diseases Center of Florida, PLLC CurrentSince Nov 1, 2023 Accepting new patients
Lincon Medical and Mental Center Past Accepting new patients
Advanced Healthcare SC Gastroenterology Past Accepting new patients
Downtown Bronx Medical Associates PC Past Accepting new patients
Digestive Diseases Center of Florida, PLLC Past Accepting new patients

Locations

204 E 19th St
Panama City, FL 32405
Phone (850) 763-5409

Interoperability endpoints

  • Direct secure messaging: cchan577@direct.myadvocateaurora.org
  • Direct secure messaging: chan.cesarjr.p1@direct.ddc.nextgenshare.com

Organizations & group practices 5

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 4

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1679519797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 E 19TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054707",
            "telephone_number": "850-763-5409",
            "fax_number": "850-763-4072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 E 19TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054707",
            "telephone_number": "850-763-5409",
            "fax_number": "850-763-4072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "CESAR",
        "middle_name": "A.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WI",
            "license": "42817",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME162947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34034200",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00705300",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cchan577@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "N84W16889 Menomonee Ave",
            "city": "Menomonee Falls",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530512810",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "N84W16889 Menomonee Ave",
            "city": "Menomonee Falls",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530512810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.