MR. KYLE CHAN P.A.C.
NPI 1720016983
Physician Assistant - Medical in Long Island City, NY
About Mr. Kyle Chan P.a.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. KYLE CHAN P.A.C. (NPI 1720016983) is an individual medical provider in Long Island City, New York, licensed in New York (005143) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mr. Kyle Chan P.a.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Kyle Chan's NPI number?
The NPI number for Kyle Chan is 1720016983. It was assigned to this individual provider in the NPPES registry on June 28, 2006.
Where is Kyle Chan located?
Kyle Chan practices at 2510 30th Ave, Long Island City, NY 11102. The listed phone number is (718) 267-4390.
What is Kyle Chan's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Kyle Chan enrolled in Medicare?
Yes. Kyle Chan is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Kyle Chan was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Mr. Kyle Chan, P.A.C. · NPI 1720016983
Medical physician in Long Island City, New York. Individual provider, active in the CMS NPPES registry since June 28, 2006.
## Identity
- **NPI:** 1720016983 (Entity type: Individual)
- **Enumerated:** June 28, 2006
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **State license:** 005143 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 2510 30TH AVE, Long Island City, NY 11102-2448
- **Phone:** (718) 267-4390
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** July 8, 2007
- **Other identifiers:** Medicare UPIN P36827 (NY); Medicaid 2165320 (NY); Medicare ID-Type Unspecified 04211Z (NY)
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Source: [NPI Profile](https://npiprofile.com/npi/1720016983) · Data from the CMS NPPES public registry.