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

Q: 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.

Q: What is Jack Chan's specialty?

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

Q: 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 9 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.

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: August 09, 2026.

On this page

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

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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 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.

Other Providers at the Same Location NPPES 7

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

DR. MANUEL G SANCHEZ MD

Pain Medicine (Interventional Pain Medicine)