Active NPI
Andrew T Chan, M.D.
- Gastroenterology Physician
- Boston, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 210410
- Practice address
- 55 Fruit St
Boston, MA 02114-2621 - Phone
- (617) 726-3212
- Fax
- (617) 724-6832
- NPI assigned
- Jun 22, 2005
- Last updated
- Aug 4, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 210410 | MA | Primary |
Addresses
Primary practice location
55 Fruit St
Boston, MA 02114-2621
Mailing address
55 Fruit St
GRJ-722
Boston, MA 02114-2621
Phone (617) 726-3212
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 994677 | Other | MA | NETWORK HEALTH |
| AA13929 | Other | MA | HARVARD PILGRIM HEALTHCAR |
| J23432 | Other | MA | BLUE CROSS BLUE SHIELD |
| 0024168 | Other | MA | NEIGHBORHOOD HEALTH PLAN |
| 0134031 | Medicaid | MA | |
| 30205076 | Other | NH | NH MEDICAID |
| 6584416 | Other | CIGNA | |
| H40331 | Other | NH | ANTHEM BLUE CROSS |
| 210410 | Other | MA | TUFTS HEALTH PLAN |
| 6831017 | Other | MA | HEALTHSOURCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- Harvard Medical School, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1 Hutchinson Dr
Danvers, MA 01923-3748
Phone (978) 739-6950
1 Park Way
Haverhill, MA 01830-6278
Phone (978) 521-3210
55 Fruit St
Boston, MA 02114-2621
Phone (617) 726-2000
55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287
Hospital & facility affiliations
- Massachusetts General Hospital
- Holy Family Hospital
- Anna Jaques Hospital
- North Shore Medical Center -
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 31 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 19 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 210410 | MA | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The General Hospital Corporation | Current | Accepting new patients | |
| General Hospital Corp | Current | Accepting new patients | |
| Mass General Brigham Community Physicians Inc | Current | Accepting new patients | |
| Mass General Brigham Medical Group Northern Massachusetts Inc | Current | Accepting new patients | |
| Massachusetts General Physicians Organization Inc | Current | Accepting new patients | |
| Mass General Brigham Community Physicians Inc. | Gastroenterology | Current | Accepting new patients |
Locations
55 Fruit St
Boston, MA 02114
55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967
55 Fruit St
#4
Boston, MA 02114
Phone (617) 724-2229
55 Fruit St
#722
Boston, MA 02114
Phone (617) 724-6113
1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950
66 E Main St
Georgetown, MA 01833
Phone (978) 352-7780
1 Parkway
Haverhill, MA 01830
Phone (978) 521-3210
500 Merrimack St
Lawrence, MA 01843
Phone (978) 557-8800
170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000
Interoperability endpoints
- chan.andrewt.mgh@direct.partners.masshiway.net
Organizations & group practices 6
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.
-
- Internal Medicine Physician
- Haverhill, MA
- NPI 1891112637
Gastroenterology
-
- Emergency Medicine Physician
- Salem, MA
- NPI 1588606123
-
- Dermatology Physician
- Boston, MA
- NPI 1801874573
-
- General Acute Care Hospital
- Boston, MA
- NPI 1023049236
-
dba Massachusetts General Hospital Outpatient Pharmacy
- General Acute Care Hospital
- Boston, MA
- NPI 1508390014
-
- Cardiovascular Disease Physician
- Medford, MA
- NPI 1548638265
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Newburyport, MA
- NPI 1992779482
-
dba Merrimack Health Methuen Hospital
- General Acute Care Hospital
- Methuen, MA
- NPI 1265267991
-
dba Salem Hospital
- General Acute Care Hospital
- Salem, MA
- NPI 1730121633
-
- General Acute Care Hospital
- Boston, MA
- NPI 1023049236
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280880000000",
"number": "1982600144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 FRUIT ST",
"address_2": "GRJ-722",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142621",
"telephone_number": "617-726-3212",
"fax_number": "617-724-6832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 FRUIT ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142621",
"telephone_number": "617-726-3212",
"fax_number": "617-724-6832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "ANDREW",
"middle_name": "T",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-22",
"last_updated": "2010-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "MA",
"license": "210410",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NETWORK HEALTH",
"identifier": "994677",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM HEALTHCAR",
"identifier": "AA13929",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "J23432",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH PLAN",
"identifier": "0024168",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0134031",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NH MEDICAID",
"identifier": "30205076",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "6584416",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "H40331",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "210410",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHSOURCE",
"identifier": "6831017",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; 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.