Suisun Simon Chan, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

A42588 Issued in CA

Practice address

500 N Garfield Ave
Suite 308
Monterey Park, CA 91754-1242

Phone

(626) 288-8292

Fax

(626) 288-8789

NPI assigned

Jul 19, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

GastroenterologyAlso: Family Practice, Internal Medicine

Education

Icahn School of Medicine at Mount Sinai, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Princeton Physicians Associates Inc.

  • Gastroenterology Physician
  • San Gabriel, CA
  • NPI 1841217726
  Medicare reassignment Authorized official
• Alhambra Hospital Medical Center, LP

  • General Acute Care Hospital
  • Alhambra, CA
  • NPI 1811099674
  NPD (past)
• Chinatown Service Center

  • Case Manager/Care Coordinator
  • Alhambra, CA
  • NPI 1134482326
  NPD (past)
• Tit Sang Li MD & Nga Wan Wong MD Inc

  • Ambulatory Family Planning Facility
  • Huntington Beach, CA
  • NPI 1124119979
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1801815527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N GARFIELD AVE",
            "address_2": "SUITE 308",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541242",
            "telephone_number": "626-288-8292",
            "fax_number": "626-288-8789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N GARFIELD AVE",
            "address_2": "SUITE 308",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541242",
            "telephone_number": "626-288-8292",
            "fax_number": "626-288-8789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "SUISUN",
        "middle_name": "SIMON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A42588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ53947Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0071580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Freddy Chan, P.A.
• Hilary Gissele Chan
• Nicole Chan, LCSW
• Phoebe Lai-Ying Chan, M.S.S.W.
• Randall Chan, MD
• Wan Ho Chan
• Winnie Chan
• Chang Medical, a Professional Corporation
• Andy Chang, ACUPUNCTRUIST
• Chen Tsung Chang, D.D.S.

• Gastroenterology Physician in Monterey Park, CA
• Providers in Monterey Park, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.