Amber Chan

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9719 Issued in AZ

Practice address

2420 W Baseline Rd
Tempe, AZ 85283-1040

Phone

(602) 437-0097

NPI assigned

Apr 11, 2023

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1912693284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 W BASELINE RD",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831040",
            "telephone_number": "602-437-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 W BASELINE RD",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831040",
            "telephone_number": "602-437-0097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "485 S Dobson Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852245600",
            "country_code": "US",
            "telephone_number": "480-666-6237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "AMBER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-11",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "9719",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bobbi Chagolla
• Stephen David Chakmakian, D.O.
• Swapna Chalasani, MD
• Anne Marie Chalmers
• Peggy Chambers, SLP
• Chandental PLLC
• Katrina Olivia Chandler
• Chandrakant B Patel MD PC
• Yu-Chieh Chang, MM, MT-BC, NMT
• Changing Minds Psychiatry Az LLC

• Physician Assistant in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.