NPIMap

Individual provider Active NPI

Chan Andries, PA-C

  • Surgical Physician Assistant
  • Hartford, CT
National Provider Identifier
1912196478
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
002002 Issued in CT
Practice address
114 Woodland St
Surgery Dept
Hartford, CT 06105-1208
Phone
(860) 714-5237
NPI assigned
Oct 22, 2007
Last updated
Dec 18, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 002002 CT Primary

Addresses

Primary practice location

114 Woodland St
Surgery Dept
Hartford, CT 06105-1208

Mailing address

1000 Asylum Ave
Suite 2109a
Hartford, CT 06105-1770
Phone (860) 714-6581

Other identifiers 1

IdentifierTypeStateIssuer
003020021MedicaidCT

Other names 1

  • Chan Chu Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071227000271 CT Practitioner - Physician Assistant 2668552951 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians
Hartford HospitalGroup PAC ID 2567366016, 1,040 clinicians

Practice addresses (Care Compare)

1244 Storrs Rd
Road
Storrs, CT 06268-2200
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109-4337
Phone (860) 827-7695

704 Hebron Ave
Glastonbury, CT 06033-5020

80 Seymour St
Hartford, CT 06102-8000
Phone (860) 545-7500

85 Seymour St
Hartford, CT 06106-5501
Phone (860) 696-4306

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.63 of 100Reported as group
Quality
75.35
Promoting interoperability
100
Improvement activities
40
Cost
71.44

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2002CTMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC Surgical CurrentSince Sep 1, 2019 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Sep 1, 2019 Accepting new patients
Hartford Hospital CurrentSince Feb 13, 2012 Accepting new patients
Hartford Hospital CurrentSince Feb 13, 2012 Accepting new patients
Trinity Health of New England Provider Network Organization Inc Past Accepting new patients
Saint Francis Care Medical Group, PC Past Accepting new patients
Franklin Medical Group, PC Past Accepting new patients

Locations

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

360 Bloomfield Ave
Ste 209
Windsor, CT 06095
Phone (860) 688-1311

Interoperability endpoints

  • Direct secure messaging: chan.andries.1@12982.direct.athenahealth.com
  • Direct secure messaging: chan.andries@xdr.hhchealthdirect.org

Organizations & group practices 7

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 7

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": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387324800000",
    "number": "1912196478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ASYLUM AVE",
            "address_2": "SUITE 2109A",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051770",
            "telephone_number": "860-714-6581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 WOODLAND ST",
            "address_2": "SURGERY DEPT",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051208",
            "telephone_number": "860-714-5237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRIES",
        "first_name": "CHAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-22",
        "last_updated": "2013-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "002002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003020021",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHAN",
            "last_name": "CHU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.