Jason Chan
Individual provider Active NPI Orthopaedic Surgery Physician · Redlands, CA
NPI 1891229050 · NPPES record last updated Aug 18, 2023
Key facts
- NPI
- 1891229050
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- License
- A188545 (CA)
- Practice address
- 1901 W Lugonia Ave Ste 120
Redlands, CA 92374-9704 - Phone
- (909) 557-1600
- NPI assigned
- Apr 14, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 16
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Orthopedic Surgery
- Education
- University of Michigan Medical School, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- San Bernardino Medical Orthopaedic Group Inc
Practice addresses (Care Compare)
1901 W Lugonia Ave
Suite 120 130
Redlands, CA 92374-9703
Phone (909) 557-1600
Hospital & facility affiliations
- American Eagle Home Health Care, Inc.
- Redlands Community Hospital
- Arrowhead Regional Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hip replacement | 16 |
| Knee replacement | 22 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CO, CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220804002173 | CO | Practitioner - Orthopedic Surgery | 5496137697 | Reassigns benefits to 1 organization |
| I20230921003730 | CA | Practitioner - Orthopedic Surgery | 5496137697 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A188545 | CA | MD | Adult Reconstructive Orthopaedic Surgery Physician |
| DR.0067944 | CO | MD | Adult Reconstructive Orthopaedic Surgery Physician |
Practice roles (7 of 8)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Bernardino Medical Orthopaedic Group, Inc. | Orthopaedic Surgery | Current |
Accepting new patients |
| Denver Health and Hospital Authority | Current |
Accepting new patients | |
| Denver Health and Hospital Authority | Current |
Accepting new patients | |
| San Bernardino Medical Orthopaedic Group, Inc. | Orthopaedic Surgery | Current |
Accepting new patients |
| Dignity Health | Past | Accepting new patients | |
| University of Colorado Hospital Authority | Past | Accepting new patients | |
| San Bernardino Medical Orthopaedic Group, Inc. | Orthopaedic Surgery | Past | Accepting new patients |
Locations
400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800
3889 W Stetson Ave
Ste 100
Hemet, CA 92545
Phone (951) 652-1600
1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810
1801 Orange Tree Ln
Ste 240
Redlands, CA 92374
1901 W Lugonia Ave
Ste 230240
Redlands, CA 92374
1901 W Lugonia Ave
Ste 120
Redlands, CA 92374
Phone (909) 557-1626
1901 W Lugonia Ave
Ste 310
Redlands, CA 92374
Phone (909) 793-2964
1801 Orange Tree Ln
Ste 200
Redlands, CA 92374
Phone (909) 557-1607
4234 Riverwalk Pkwy
Ste 200
Riverside, CA 92505
Phone (951) 977-2500
2131 Elks Dr
Ste 200
San Bernardino, CA 92404
Phone (909) 726-6100
777 Bannock St
Denver, CO 80204
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Reconstructive Orthopaedic Surgery Physician | 207XS0114X | DR.0067944 | CO | |
| Adult Reconstructive Orthopaedic Surgery Physician | 207XS0114X | A188545 | CA | |
| Orthopaedic Surgery Physician | 207X00000X | A188545 | CA | Yes |
Addresses
Primary practice location
1901 W Lugonia Ave Ste 120
Redlands, CA 92374-9704
Mailing address
1901 W Lugonia Ave Ste 120
Redlands, CA 92374-9704
Phone (909) 557-1600
Other practice location 1
1635 Aurora Ct Fl 4
Aurora, CO 80045-2541
Phone (720) 848-4000
Other practice location 2
90 Bergen St
Department of Orthopaedics, Doctor's Office Center
Newark, NJ 07103-2425
Phone (973) 972-5350
Other providers in Redlands, CA
- Chamberlain Family Orthodontics Inc., a Dental Practice
- Alexandra Mascaro Chamberlain-Umanoff
- Craig Allen Chamberlain
- Aaron Chambers
- Gary H Chan
- Kevin Jan Chan
- Lap Fan Chan
- Thomas Kanianthara Chandy
- Albert Jeh-Seng Chang
- David Chang
All providers in Redlands, CA · Orthopaedic Surgery Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.