Individual provider Active NPI

Wendy M Chan, MD

  • Emergency Medicine Physician
  • Maplewood, NJ
National Provider Identifier
1932549474
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
287072 Issued in NY
Practice address
13 Oakland Rd
Maplewood, NJ 07040-2224
Phone
(718) 245-3318
Fax
(718) 245-4799
NPI assigned
Jun 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 287072 NY Primary

Addresses

Primary practice location

13 Oakland Rd
Maplewood, NJ 07040-2224

Mailing address

13 Oakland Rd
Maplewood, NJ 07040-2224
Phone (646) 594-9038

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170721001199 NY Practitioner - Emergency Medicine 2365712403 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients
Maimonides Medical Center - MMC Emergency Physicians FPP Emergency Medicine CurrentSince Aug 15, 2017 Accepting new patients
Kings County Hospital Center Past Accepting new patients

Locations

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

2525 Kings Hwy
Brooklyn, NY 11229
Phone (718) 692-5300

450 Clarkson Ave
#1228
Brooklyn, NY 11203
Phone (718) 245-3318

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: wendychan@mai.allscriptsdirect.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1932549474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 OAKLAND RD",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070402224",
            "telephone_number": "646-594-9038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 OAKLAND RD",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070402224",
            "telephone_number": "718-245-3318",
            "fax_number": "718-245-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "WENDY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-28",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "287072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, NJ

Sources for this page

Verify at the official NPI Registry.