ANDY NAN - NPI 1104708254 - Physician Assistant in Elmhurst, NY

Q: What is Andy Nan's NPI number?

The NPI number for Andy Nan is 1104708254. It was assigned to this individual provider in the NPPES registry on July 21, 2025.

Q: What is Andy Nan's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Andy Nan was last updated on July 21, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Andy Nan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANDY NAN (NPI 1104708254) is an individual physician assistant in Elmhurst, New York and active in the NPI registry since July 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1104708254

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameANDY NAN

Location Address9425 60TH AVEElmhurst, NY 11373-5069

Mailing Address209 Evergreen AveBethpage, NY 11714-1221 · (347) 384-0521

Phone(718) 760-0797

Sole ProprietorYes

Medical School CMSOtherGraduated 2025

Enumeration DateJuly 21, 2025

NPPES CertifiedJuly 21, 2025

✔ NPI 1104708254 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

9425 60TH AVE, Elmhurst, NY 11373

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Andy Nan is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9436627361

PECOS Enrollment IDI20260508000503

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11373 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$104.17 typical visit price

range $67.00 – $201.98

Typical copayment $26.04 (range $16.75 – $50.49)

Most-billed visit code 99203

Established Patient

$82.96 typical visit price

range $21.62 – $163.52

Typical copayment $20.74 (range $5.40 – $40.88)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.