Individual provider Active NPI

Chun-Kit Chan, D.O.

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1730284308
Registry record updated Jan 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
202125 Issued in NY
Practice address
2 Mott St RM 305
New York, NY 10013-5097
Phone
(212) 791-6968
Fax
(212) 791-6983
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 202125 NY Primary

Addresses

Primary practice location

2 Mott St RM 305
New York, NY 10013-5097

Mailing address

2 Mott St RM 305
New York, NY 10013-5097
Phone (212) 791-6968

Other identifiers 2

IdentifierTypeStateIssuer
02164905MedicaidNY
WANQ41OtherMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20070226000605 NY Practitioner - Internal Medicine 8527160357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chinatown True Care Medical PLLCGroup PAC ID 2163859760, 245 clinicians

Practice addresses (Care Compare)

128 Mott St
Suite 206 207
New York, NY 10013-5540
Phone (212) 680-0528

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
70.9
Promoting interoperability
100
Improvement activities
40
Cost
100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chinatown True Care Medical PLLC Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients

Locations

833 58th St
Brooklyn, NY 11220
Phone (718) 290-2919

4235 Main St
Ste 3E
Flushing, NY 11355
Phone (718) 886-5068

128 Mott St
Ste 206207
New York, NY 10013
Phone (212) 680-0528

2 Mott St
Rm 305
New York, NY 10013
Phone (212) 791-6968

Networks

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

Interoperability endpoints

  • Direct secure messaging: ckchan@1148.mdlanddirect.com

Organizations & group practices 1

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389225600000",
    "number": "1730284308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MOTT ST RM 305",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100135097",
            "telephone_number": "212-791-6968",
            "fax_number": "212-791-6983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MOTT ST RM 305",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100135097",
            "telephone_number": "212-791-6968",
            "fax_number": "212-791-6983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "CHUN-KIT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2014-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "202125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02164905",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "WANQ41",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.