Individual provider Active NPI

Yik Han Chan, MA, RD, CDN, CDCES

  • Registered Dietitian
  • Forest Hills, NY
National Provider Identifier
1699158352
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1057883
Practice address
6721 Exeter St
Forest Hills, NY 11375-4149
Phone
(267) 693-7088
Fax
(215) 748-9237
NPI assigned
Jun 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1057883 Primary

Addresses

Primary practice location

6721 Exeter St
Forest Hills, NY 11375-4149

Mailing address

6721 Exeter St
Forest Hills, NY 11375-4149
Phone (267) 693-7088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250602001316 NY Practitioner - Registered Dietitian Or Nutrition Professional 8729597703 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince May 1, 2025 Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

1111 Marcus Ave
Ste M10C
New Hyde Park, NY 11042
Phone (516) 266-3500

300 Community Dr
Plandome, NY 11030

Networks

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1699158352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6721 EXETER ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754149",
            "telephone_number": "267-693-7088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6721 EXETER ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754149",
            "telephone_number": "267-693-7088",
            "fax_number": "215-748-9237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "YIK HAN",
        "credential": "MA, RD, CDN, CDCES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-30",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "1057883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.