Fonda Chan

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

R6985 Issued in TX

Practice address

8390 Lyndon B Johnson Fwy Ste 1000
Dallas, TX 75243-1288

Phone

(214) 750-9977

Fax

(214) 750-9983

NPI assigned

Aug 10, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, OK, MO3 enrollments

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 3

Specialty

Neurology

Education

Boston University School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Access Telecare PLLCGroup PAC ID 7810204831, 409 clinicians

Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fondachan@ncdpa.allscriptsdirect.net

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.

• Access Telecare, PLLC

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1013303080

  MO

  Medicare reassignment Care Compare group NPD
• Integris Ambulatory Care Corporation

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1750333936

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Neurology Consultants of Dallas, P.a.

  • Neurology Physician
  • Dallas, TX
  • NPI 1780875807
  Medicare reassignment NPD
• Truman Medical Center, Incorporated

  • General Acute Care Hospital
  • Kansas City, MO
  • NPI 1144207937
  Medicare reassignment NPD
• Thrive Neurology and Wellness PLLC

  • Neurology Physician
  • Dallas, TX
  • NPI 1841124302
  NPD Authorized official
• Truman Medical Center, Incorporated

  • Otolaryngology Physician
  • Kansas City, MO
  • NPI 1184893224
  NPD
• Truman Medical Center, Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kansas City, MO
  • NPI 1225773401
  NPD

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

• Integris Baptist Medical Center Inc

  • Psychiatric Hospital Unit
  • Oklahoma City, OK
  • NPI 1598837221
  Care Compare affiliation
• Integris Baptist Medical Center Inc

  • Psychiatric Hospital Unit
  • Spencer, OK
  • NPI 1659443372
  Care Compare affiliation
• Integris Baptist Medical Center Inc

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1831103654
  Care Compare affiliation
• Integris Baptist Medical Center Inc

  • Psychiatric Hospital Unit
  • Spencer, OK
  • NPI 1881760759
  Care Compare affiliation

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

{
    "created_epoch": "1344556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1831446665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 GARDNER ST APT 11",
            "city": "ALLSTON",
            "state": "MA",
            "postal_code": "021342236",
            "telephone_number": "410-258-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8390 LYNDON B JOHNSON FWY STE 1000",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752431288",
            "telephone_number": "214-750-9977",
            "fax_number": "214-750-9983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "FONDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-10",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "252590",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "R6985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Kyungyee Chan
• Cecilia Chan, PHARMD
• Chihyo Sophia Chan
• Chrissy Chan, MD
• Christina Snow Chan, M.D.
• Hilda Lyn Chan
• Isaac Chan
• Jaclyn Chan, MD
• Jeffrey Allen Chan
• Lianna Chan

• Neurology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Neurology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.