Conner Chan, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

P2424 Issued in TX

Practice address

3730 Emmett Hutto Blvd
Baytown, TX 77521-1764

Phone

(281) 425-9375

Fax

(281) 427-4584

NPI assigned

May 21, 2008

Last updated

May 12, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 TX

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

Specialty

Dermatology

Education

University of Texas Medical Branch at Galveston, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baytown Dermatology PAGroup PAC ID 7810899580, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.06 of 100Reported as individual

Quality

86.84

Promoting interoperability

91

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Baytown Dermatology, P.a.

  • Dermatology Physician
  • Baytown, TX
  • NPI 1033325550
  Medicare reassignment Care Compare group NPD Authorized official
• Baytown Dermatology, P.a.

  dba Baytown Dermatopathology Laboratory

  • Clinical Medical Laboratory
  • Baytown, TX
  • NPI 1962599217
  NPD Authorized official

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1962669515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3730 EMMETT HUTTO BLVD",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775211764",
            "telephone_number": "281-425-9375",
            "fax_number": "281-427-4584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3730 EMMETT HUTTO BLVD",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775211764",
            "telephone_number": "281-425-9375",
            "fax_number": "281-427-4584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "CONNER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-21",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "P2424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaunteel L Chalk, CNM
• Lyla S Challa, MD
• Sarma S Challa, M.D.
• Chambers County Public Hospital District No 1 (Omni Point Health Primary Care Mont Belvieu)
• Chambers County Public Hospital District No. 1 (Focused Care at Burnet Bay)
• Chandalia Abate PLLC
• Manisha Chandalia, MD
• Changing Tides Wellness and Advisors PLLC
• Charles D Wilkins
• Charles Holt

• Dermatology Physician in Baytown, TX
• Providers in Baytown, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2020; 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.