Individual provider Active NPI

Catherine Chan

  • Nurse Practitioner
  • San Gabriel, CA
National Provider Identifier
1821697525
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95015178 Issued in CA
Practice address
207 S Santa Anita St Ste P05
San Gabriel, CA 91776-1159
Phone
(626) 652-7433
NPI assigned
Oct 22, 2020
Last updated
Jan 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered Nurse 163WP2201X 825283 CA
Nurse Practitioner 363L00000X 95015178 CA Primary

Addresses

Primary practice location

207 S Santa Anita St Ste P05
San Gabriel, CA 91776-1159

Mailing address

207 S Santa Anita St Ste P05
San Gabriel, CA 91776-1159
Phone (266) 526-7433

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210112002489 CA Practitioner - Nurse Practitioner 9032522024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
City of Hope Medical FoundationGroup PAC ID 3779751656, 964 clinicians

Practice addresses (Care Compare)

1500 Duarte Rd
Duarte, CA 91010-3012
Phone (626) 256-4673

1500 E Duarte Rd
Duarte, CA 91010-3012

209 Fair Oaks Ave
South Pasadena, CA 91030-1814
Phone (626) 396-2900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.8 of 100Reported as group
Quality
78.51
Promoting interoperability
100
Improvement activities
40
Cost
70.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
825283CAMDAmbulatory Care Registered Nurse
95015178CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
City of Hope Medical Foundation CurrentSince Feb 7, 2022 Accepting new patients
Ahmc San Gabriel Valley Medical Past Accepting new patients
Ahmc Garfield Medical Center LP Past Accepting new patients
Alhambra Hospital Medical Center, LP Past Accepting new patients

Locations

1500 Duarte Rd
Duarte, CA 91010
Phone (626) 359-8111

209 Fair Oaks Ave
South Pasadena, CA 91030
Phone (626) 359-8111

425 Haaland Dr
Ste 103
Thousand Oaks, CA 91361
Phone (805) 345-2020

Interoperability endpoints

  • Direct secure messaging: cchan99481@cityofhope.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1821697525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 S SANTA ANITA ST STE P05",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761159",
            "telephone_number": "266-526-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 S SANTA ANITA ST STE P05",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761159",
            "telephone_number": "626-652-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "CATHERINE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-22",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "CA",
            "license": "825283",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95015178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

Verify at the official NPI Registry.