Katherine Fair Chan, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Practice address

1199 Pleasant Valley Way
West Orange, NJ 07052-1424

Phone

(973) 731-3600

NPI assigned

Jul 31, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kessler Professional Services LLCGroup PAC ID 2860462652, 42 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

84.21 of 100Reported as group

Quality

78.56

Improvement activities

40

Cost

70.02

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Kessler Professional Services LLC

  • Specialist
  • West Orange, NJ
  • NPI 1508804048
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1922652577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 ARMSTRONG RD # 116B",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490377314",
            "telephone_number": "269-966-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 PLEASANT VALLEY WAY",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521424",
            "telephone_number": "973-731-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Market St",
            "address_purpose": "LOCATION",
            "city": "Saddle Brook",
            "state": "NJ",
            "postal_code": "076635309",
            "country_code": "US",
            "telephone_number": "201-368-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "KATHERINE",
        "middle_name": "FAIR",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CFNT LLC (Home Life Recovery)
• Fadi Nemer Chaaban, M.D.
• Izzat Chaaban, PT, DPT
• Chaman Preet Singh Chahal, M.D.
• Elie Youssef Chakhtoura, M.D.
• Yi Hung Chan, DPM
• Kaliq Trimble Chang, MD
• Patrick Kung Sun Chang, M.D.
• Peiyun Chang, D.O.
• Charles M Cummins, OD, PA

• Clinical Neuropsychologist in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Clinical Neuropsychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; 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.