NPIMap

Individual provider Active NPI

Derek Victor Chan, M.D., PH.D.

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1932488574
Registry record updated Sep 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
279602 Issued in NY
Practice address
928 Broadway Ste 301
New York, NY 10010-8156
Phone
(212) 606-3780
Fax
(212) 606-3785
NPI assigned
Aug 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X DR.0055946 CO
Dermatology Physician 207N00000X 279602 NY Primary

Addresses

Primary practice location

928 Broadway Ste 301
New York, NY 10010-8156

Mailing address

928 Broadway Ste 301
New York, NY 10010-8156
Phone (212) 606-3780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151222001446 NY Practitioner - Dermatology 9032346200 Reassigns benefits to 2 organizations
I20230329000461 TX Practitioner - Dermatology 9032346200 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Boston University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eagle Butte Indian Health Service HospitalGroup PAC ID 7517852759, 42 clinicians

Practice addresses (Care Compare)

10110 S 7650
Crow Agency, MT 59022-0009
Phone (406) 638-4616

24276 166TH Airport Rd
Eagle Butte, SD 57625-1022
Phone 60596477240515

245 5TH Ave
FL 3
New York, NY 10016-8728
Phone (212) 606-3780

PO Box
Suite 1012
Eagle Butte, SD 57625-1012

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.52 of 100Reported as group
Quality
68.64
Promoting interoperability
91
Improvement activities
40
Cost
86.31

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions11
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
DR.0055946COMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monica Halem MD PC Dermatology CurrentSince Nov 15, 2021 Accepting new patients
Eagle Butte Indian Health Service Hospital CurrentSince Jan 12, 2023 Accepting new patients
US Health Dept of Health & Human Services Current Accepting new patients
All Dermis Dermatology, PC Dermatology CurrentSince Apr 1, 2023 Accepting new patients
Rosebud Indian Health Service CurrentSince Feb 16, 2024 Accepting new patients
Rosebud Indian Health Service CurrentSince Feb 16, 2024 Accepting new patients
US Dept of HHS Past Accepting new patients
U S Health Dept of Health & Human Services Past Accepting new patients
Howard D. Solomon, DO, PC Dermatology Past Accepting new patients
U S Health Dept of Health & Human Services Past Accepting new patients
Anthony Buglino DO PLLC Past Accepting new patients

Locations

669 Agency Main St
Harlem, MT 59526
Phone (406) 353-3100

107 H St
Poplar, MT 59255
Phone (406) 738-3491

119 W 57th St
Ste 212
New York, NY 10019
Phone (212) 421-1740

245 5th Ave
Fl 3
New York, NY 10016
Phone (212) 302-4399

Interoperability endpoints

  • Direct secure messaging: dchan@advderm.emadirect.md

Organizations & group practices 11

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 3

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": "1313280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790380800000",
    "number": "1932488574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 BROADWAY STE 301",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100108156",
            "telephone_number": "212-606-3780",
            "fax_number": "212-606-3785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 BROADWAY STE 301",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100108156",
            "telephone_number": "212-606-3780",
            "fax_number": "212-606-3785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "DEREK",
        "middle_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-14",
        "last_updated": "2026-09-26",
        "certification_date": "2026-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "DR.0055946",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "279602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.