SAMUEL CHAN
NPI 1518587773
Physical Therapist in Staten Island, NY

Active since April 17, 2020
143 DARNELL LN, STATEN ISLAND, NY 10309(718) 227-6244 Get Directions Write a Review

NPPES record last updated: July 17, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 17, 2023, Apr 17, 2020 (2 updates tracked since 2020).

About Samuel Chan NPPES

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

SAMUEL CHAN (NPI 1518587773) is an individual physical therapist in Staten Island, New York, licensed in New York (045102) and active in the NPI registry since April 2020. He is a graduate of Other (2019).

NPPES Registry Identity

NPI1518587773
Entity TypeIndividualMale
Primary Taxonomy225100000X
Provider Legal NameSAMUEL CHAN
Location Address143 DARNELL LNStaten Island, NY 10309-1954
Mailing Address143 Darnell LnStaten Island, NY 10309-1954
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateApril 17, 2020
Last NPPES UpdateJuly 17, 20232 updates tracked since enumeration
NPPES CertifiedJuly 17, 2023
✔ NPI 1518587773 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License✔ Licensed in NY · 045102
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
143 DARNELL LN, Staten Island, NY 10309

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

PECOS PAC ID6800323445
PECOS Enrollment IDI20241220002580

Medicare Billing Reassignment

Medicare enrollment records show Samuel Chan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Physical Therapy
295 MADISON AVE, SUITE 1801
New York, NY 10017
  • Reassigned Medicare billing, New York enrollment
  • 24 clinicians in this Medicare group

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

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 Samuel Chan's NPI number?

The NPI number for Samuel Chan is 1518587773. It was assigned to this individual provider in the NPPES registry on April 17, 2020.

Where is Samuel Chan located?

Samuel Chan practices at 143 Darnell Ln, Staten Island, NY 10309. The listed phone number is (718) 227-6244.

What is Samuel Chan's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Samuel Chan enrolled in Medicare?

Yes. Samuel Chan is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Samuel Chan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Chan reassigns Medicare benefits to Bespoke Treatments Physical Therapy PC (New York, NY). The 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 Samuel Chan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Samuel Chan was last updated on July 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.