Rainer Quijada Chan, M.D.
Individual provider Active NPI Family Medicine Physician · St Petersburg, FL
NPI 1972794790 · NPPES record last updated Sep 28, 2018
Key facts
- NPI
- 1972794790
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- ME99142 (FL)
- Practice address
- 900 49TH St N
St Petersburg, FL 33710-6625 - Phone
- (813) 915-5459
- Fax
- (727) 201-4147
- NPI assigned
- Aug 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 10
Owned or controlled facilities with NPI records 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Loma Linda University School of Medicine, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Adventist Health System Sunbelt Inc
Practice addresses (Care Compare)
33670 US Hwy 19 N
Palm Harbor, FL 34684-2640
Phone (727) 221-5794
4660 13TH St
Saint Cloud, FL 34769-6765
Phone (407) 200-2300
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Adventhealth Zephyrhills |
Hospital | Corporate Director | Jun 7, 2018 |
| Adventhealth Dade City |
Hospital | Corporate Director | Jun 7, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071228000084 | FL | Practitioner - Family Practice | 5597845842 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME99142 | FL | MD | Family Medicine Physician |
Practice roles (9 of 10)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Hospital Zephyrhills Inc | Current |
Accepting new patients | |
| Adventist Health System Sunbelt Inc | Family Medicine | Current | Accepting new patients |
| Adventist Health Systems Sunbelt Inc | Current |
Accepting new patients | |
| Florida Hospital Physician Group Inc | Family Medicine | Current |
Accepting new patients |
| Adventist Health System-Sunbelt, Inc | Current |
Accepting new patients | |
| Adventist Health System Sunbelt Inc | Family Medicine | Current | Accepting new patients |
| Florida Hospital Zephyrhills Inc | Current |
Accepting new patients | |
| Adventist Health System/Sunbelt, Inc. | Family Medicine | Current |
Accepting new patients |
| Adventist Health System/Sunbelt, Inc | Family Medicine | Current |
Accepting new patients |
Locations
900 Hope Way
Forest City, FL 32714
Phone (407) 357-1255
7975 Lake Underhill Rd
Ste 200
Orlando, FL 32822
Phone (407) 303-5990
4660 13th St
Saint Cloud, FL 34769
Phone (321) 805-4650
900 49th St N
St Petersburg, FL 33710
Phone (727) 327-8801
13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260
2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209
7050 Gall Blvd
Zephyrhills, FL 33541
Phone (813) 779-1209
Networks
- Freedom Health HMO Network
Interoperability endpoints
- rchan73488@adventhealth.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME99142 | FL | Yes |
Addresses
Primary practice location
900 49TH St N
St Petersburg, FL 33710-6625
Mailing address
900 49TH St N
St Petersburg, FL 33710-6625
Phone (813) 915-5459
Other practice location 1
900 49th St N
St Petersburg, FL 33710-6625
Phone (813) 915-5459
Other providers in St Petersburg, FL
- Champion Comprehensive Virtual Services LLC
- Colin Chan
- Daniel Tim Chan
- Denise Michelle Chan
- Mark Chan
- Sebrina Chan
- Neha Chandan
- Himanshu V Chandarana
- Cecilia Leticia Chandler
- Nicole Chandler
All providers in St Petersburg, FL · Family Medicine Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.