Edwin Kenneth Chan, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

222486 Issued in NY

Practice address

13640 39TH Ave
Suite 6GB
Flushing, NY 11354-5536

Phone

(718) 321-8246

Fax

(718) 321-8273

NPI assigned

Mar 25, 2006

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

Other identifiers 1

Other names 1

• Dr. Edwin K Chan Professional name

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

Specialty

Otolaryngology

Education

Albert Einstein College of Medicine of Yeshiva University, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Edwin K Chan MD PCGroup PAC ID 1951456847, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

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

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.

• Edwin K Chan MD PC

  • Specialist
  • Flushing, NY
  • NPI 1710113949
  Medicare reassignment Care Compare group
• Zhenqing Brett Wu MD PLLC

  • Otolaryngology Physician
  • Flushing, NY
  • NPI 1154614436
  NPD (past)

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

{
    "created_epoch": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455753600000",
    "number": "1982664611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2625",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100098925",
            "telephone_number": "718-321-8246",
            "fax_number": "718-321-8273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13640 39TH AVE",
            "address_2": "SUITE 6GB",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545536",
            "telephone_number": "718-321-8246",
            "fax_number": "718-321-8273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "EDWIN",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-25",
        "last_updated": "2016-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "222486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02655645",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDWIN",
            "last_name": "CHAN",
            "middle_name": "K",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Bryan Chan
• Chak Hoi N/a Chan
• Connie Chan
• Daniel Chan, PHARM D
• Edward Chan, LCSW
• Florinda Chan
• Hon Chan, D.D.S
• Hong Yeol Chan, RN
• Jeanie Y Chan
• Jeffrey Chung Chan

• Specialist in Flushing, NY
• Providers in Flushing, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; 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.