1. Home
  2. Directory
  3. New Hampshire
  4. Newington
  5. Anesthesiology
  6. NPI Profile

DR. JACK CHAN MD
NPI 1376170522
Anesthesiology - Pain Medicine in Newington, NH

Active since March 26, 2020PECOS EnrolledAccepts Medicare Assignment
101 SHATTUCK WAY STE 6, NEWINGTON, NH 03801(617) 372-4018 Get Directions Write a Review

NPPES record last updated: October 15, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Jack Chan Md NPPES

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

DR. JACK CHAN MD (NPI 1376170522) is an individual pain medicine provider in Newington, New Hampshire, licensed in New Hampshire (34672) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1376170522
Entity TypeIndividualMale
Primary Taxonomy207LP2900X
Provider Legal NameDR. JACK CHANCredential: MD
Location Address101 SHATTUCK WAY STE 6Newington, NH 03801-7876
Mailing Address101 Shattuck Way Ste 6Newington, NH 03801-7876 · (617) 372-4018
Phone(617) 372-4018
Sole ProprietorYes
Medical School CMSOtherGraduated 2020
Enumeration DateMarch 26, 2020
Last NPPES UpdateOctober 15, 2025
NPPES CertifiedOctober 15, 2025
✔ NPI 1376170522 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiology · Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207LP2900X
License✔ Licensed in NH · 34672
Definition
An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.
101 SHATTUCK WAY STE 6, Newington, NH 03801
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from NH Healthy Families, WellSense Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jack Chan Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5991126435
PECOS Enrollment IDI20250821001421
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Jack Chan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Pain Surgery Center Limited Liability Company
Same address
Ambulatory Surgical
101 SHATTUCK WAY STE 7
Newington, NH 03801
  • Reassigned Medicare billing, New Hampshire enrollment
  • 2 clinicians in this Medicare group
NPI 1043955198 (603) 778-9921
Specialty Institute PLLC
Same address
Interventional Pain Medicine
101 SHATTUCK WAY STE 6
Newington, NH 03801
  • Reassigned Medicare billing, New Hampshire enrollment
  • 5 clinicians in this Medicare group
NPI 1932833621 (603) 778-9921

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAQUEL DOROTHY LEAFE
Nurse Practitioner (Family)
101 SHATTUCK WAY STE 6
NEWINGTON, NH 03801
Rockingham County (603) 383-2020
DR. MANUEL G SANCHEZ MD
Pain Medicine (Interventional Pain Medicine)
101 SHATTUCK WAY STE 6
NEWINGTON, NH 03801
Rockingham County (603) 778-9921
JEREMY GILBERT MSN, APRN, FNP-C
Nurse Practitioner (Family)
101 SHATTUCK WAY STE 6
NEWINGTON, NH 03801
Rockingham County (603) 383-2020
BERNADETTE KATHERINE GANDOLFI
Nurse Practitioner (Family)
101 SHATTUCK WAY STE 6
NEWINGTON, NH 03801
Rockingham County (603) 383-2020
DR. ANH L. NGO M.D.
Pain Medicine (Interventional Pain Medicine)
101 SHATTUCK WAY STE 6
NEWINGTON, NH 03801
Rockingham County (603) 778-9921
DANIEL BENTALL PA-C
Physician Assistant
101 SHATTUCK WAY STE 6
NEWINGTON, NH 03801
Rockingham County (603) 778-9921
DR MANUEL SANCHEZ PAIN MANAGEMENT AND INTERVENTIONS LLC
Pain Medicine (Interventional Pain Medicine)
101 SHATTUCK WAY STE 6
NEWINGTON, NH 03801
Rockingham County (603) 778-9921
SPECIALTY INSTITUTE PLLC
Pain Medicine (Interventional Pain Medicine)
101 SHATTUCK WAY STE 6
NEWINGTON, NH 03801
Rockingham County (603) 778-9921

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Chan's NPI number?

The NPI number for Jack Chan is 1376170522. It was assigned to this individual provider in the NPPES registry on March 26, 2020.

Where is Jack Chan located?

Jack Chan practices at 101 Shattuck Way Ste 6, Newington, NH 03801. The listed phone number is (617) 372-4018.

What is Jack Chan's specialty?

The primary specialty registered for this NPI is Anesthesiology, specializing in Pain Medicine, with taxonomy code 207LP2900X.

Is Jack Chan enrolled in Medicare?

Yes. Jack Chan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Jack Chan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jack Chan reassigns Medicare benefits to 2 organizations: Pain Surgery Center Limited Liability Company (Newington, NH) and Specialty Institute PLLC (Newington, NH). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jack Chan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jack Chan accept?

Health plans from Ambetter from NH Healthy Families and WellSense Health Plan list Jack Chan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jack Chan was last updated on October 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.