Dr Ethan Chan, OD in New York, NY - Medicare Optometrist Provider

Dr Ethan Chan, OD is a medicare enrolled "Optometrist" provider in New York, New York. His current practice location is 1153 2nd Ave, New York, New York. You can reach out to his office (for appointments etc.) via phone at (212) 421-3655.

Dr Ethan Chan is licensed to practice in Nevada (license number 1164) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1710671565.

Contact Information

	Dr Ethan Chan, OD
	1153 2nd Ave, New York, NY 10065-8505
	(212) 421-3655
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Ethan Chan
Gender	Male
Speciality	Optometrist
Location	1153 2nd Ave, New York, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1710671565
Provider Enumeration Date: 06/05/2023
Last Update Date: 09/12/2024

Medicare PECOS Information:

PECOS PAC ID: 5890142855
Enrollment ID: I20231113002167

Medical Identifiers

Medical identifiers for Dr Ethan Chan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1710671565	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
152W00000X	Optometrist	1164 (Nevada)	Primary
152W00000X	Optometrist	ORT010014 (New York)	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Ethan Chan allows following entities to bill medicare on his behalf.

Provider Name	Gammoh Premier Vision Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1528304458 PECOS PAC ID: 4880849843 Enrollment ID: O20141229001332

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Ethan Chan is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Ethan Chan, OD 2840 Jackson Ave Apt 12m, Long Island City, NY 11101-3304 Ph: (626) 373-4388	Dr Ethan Chan, OD 1153 2nd Ave, New York, NY 10065-8505 Ph: (212) 421-3655

Reviews and Comments

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Hmy Ophthalmic Dispenser Pc Inc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 212 3rd Ave, New York, NY 10003 Phone: 212-982-4469

Dr Ethan Chan, OD - Medicare Optometrist in New York, NY