Individual provider Active NPI

Joanne Chan, MD

  • Family Medicine Physician
  • Boston, MA
National Provider Identifier
1700103421
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
272078 Issued in MA
Practice address
800 Boylston St #151
Boston, MA 02199
Phone
(415) 349-0840
NPI assigned
Apr 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A124873 CA
Family Medicine Physician 207Q00000X 272078 MA Primary

Addresses

Primary practice location

800 Boylston St #151
Boston, MA 02199

Mailing address

46 North St
Hatfield, MA 01038-9748

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171114002152 MA Practitioner - Family Practice 7012143563 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A124873CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group Western Massachusetts Inc Family Medicine CurrentSince Nov 2, 2020 Accepting new patients
LGH Professional Services LLC Past Accepting new patients

Locations

295 Varnum Ave
Lowell, MA 01854
Phone (978) 788-7344

30 Locust St
Northampton, MA 01060
Phone (413) 582-2000

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.

NPI Registry JSON

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1700103421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 NORTH ST",
            "city": "HATFIELD",
            "state": "MA",
            "postal_code": "010389748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BOYLSTON ST #151",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02199",
            "telephone_number": "415-349-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JOANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-21",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A124873",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "272078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.