Active NPI
Raymond H Chan, M.D.
- Internal Medicine Physician
- Boston, MA
National Provider Identifier
1932400264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 80964
- Practice address
- 330 Brookline Ave
Bidmc East Campus SH 462
Boston, MA 02215-5400 - Phone
- (617) 610-9819
- NPI assigned
- Nov 3, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 80964 | ZZ | Primary |
Addresses
Primary practice location
330 Brookline Ave
Bidmc East Campus SH 462
Boston, MA 02215-5400
Mailing address
260 Independence Dr
Chestnut Hill, MA 02467-3664
Phone (617) 610-9819
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 80964 | ZZ | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288742400000",
"number": "1932400264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "260 INDEPENDENCE DR",
"city": "CHESTNUT HILL",
"state": "MA",
"postal_code": "024673664",
"telephone_number": "617-610-9819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 BROOKLINE AVE",
"address_2": "BIDMC EAST CAMPUS SH 462",
"city": "BOSTON",
"state": "MA",
"postal_code": "022155400",
"telephone_number": "617-610-9819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "RAYMOND",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-11-03",
"last_updated": "2010-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "ZZ",
"license": "80964",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.