Individual provider Active NPI

Denis T.C. Chan

  • Ph.D. Medical Genetics
  • Waipahu, HI
National Provider Identifier
1962614768
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ph.D. Medical GeneticsTaxonomy code 170100000X
License
2065 Issued in HI
Practice address
94-748 Hikimoe St Ste B
Waipahu, HI 96797-3350
Phone
(808) 671-7155
Fax
(808) 671-7155
NPI assigned
May 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ph.D. Medical Genetics 170100000X 2065 HI Primary

Addresses

Primary practice location

94-748 Hikimoe St Ste B
Waipahu, HI 96797-3350

Mailing address

94-748 Hikimoe St. Ste B
Waipahu, HI 96797-3350
Phone (808) 671-7155

Other identifiers 2

IdentifierTypeStateIssuer
030931-01MedicaidHI
0003437-1OtherHIHMSA,Q,HMA,UHA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20050929001061 HI Practitioner - Internal Medicine 3678508454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1966
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

94 -748 Hikimoe St
Suite B
Waipahu, HI 96797-3350

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2065HIMDPh.D. Medical Genetics

Practice roles

OrganizationSpecialtyStatusNew patients
Denis T. C. Chan M.D. Inc CurrentSince Jul 1, 1966 Accepting new patients

Locations

94-748 Hikimoe St
#B
Waipahu, HI 96797
Phone (808) 671-7155

94-748 Hikimoe St
Ste B
Waipahu, HI 96797
Phone (808) 671-7155

Organizations & group practices 1

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962614768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-748 HIKIMOE ST. STE B",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967973350",
            "telephone_number": "808-671-7155",
            "fax_number": "808-671-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-748 HIKIMOE ST STE B",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967973350",
            "telephone_number": "808-671-7155",
            "fax_number": "808-671-7155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "DENIS",
        "middle_name": "T.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "HI",
            "license": "2065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030931-01",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA,Q,HMA,UHA",
            "identifier": "0003437-1",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waipahu, HI

Sources for this page

Verify at the official NPI Registry.