Ian Chan MD PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

IAN CHAN MD PC

Practice address

869 57TH St Apt 102
Brooklyn, NY 11220-5192

Phone

(631) 213-1668

Fax

(718) 509-6993

NPI assigned

Jun 9, 2019

Organization subpart

No

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

Authorized official

Name

Ian Hing-Yeung ChanNPI 1942406756

Title

President

Phone

(631) 213-1668

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Ian Chan MD PC

  • Ophthalmologic Surgery Clinic/Center
  • New York, NY
  • NPI 1083058432

  O20130508000038

  Same enrollment
• Ian Chan MD PC

  • Ophthalmologic Surgery Clinic/Center
  • Flushing, NY
  • NPI 1568894590

  O20130508000038

  Same enrollment

Tax ID family

Ian Chan MD PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Ian Chan MD PC

  • Ophthalmologic Surgery Clinic/Center
  • New York, NY
  • NPI 1083058432
  NPD tax ID
• Ian Chan MD PC

  • Ophthalmologic Surgery Clinic/Center
  • Flushing, NY
  • NPI 1568894590
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ian Hing-Yeung Chan, MD

  • Ophthalmology Physician
  • New York, NY
  • NPI 1942406756
  NPD Authorized official

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

{
    "created_epoch": "1560038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631059200000",
    "number": "1710546270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 CENTRE ST PH 113",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134559",
            "telephone_number": "631-213-1668",
            "fax_number": "718-509-6993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "869 57TH ST APT 102",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112205192",
            "telephone_number": "631-213-1668",
            "fax_number": "718-509-6993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IAN CHAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-09",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "IAN",
        "authorized_official_middle_name": "HING-YEUNG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-213-1668"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/A",
            "affiliation": "N",
            "endpointDescription": "n/a",
            "address_1": "6410 8th Ave # 2A",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112204720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Ophthalmology Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.