Physician Compare National (NPI:1821195736)

HEALTHCARE PROVIDER: CHONG KIT WILLIAM CHAN D.P.M.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1821195736
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7618997289
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20051128000509
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHAN
	Individual professional last name
Provider First Name	CHONG KITWILLIAM
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	DPM
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	NEW YORK COLLEGE OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	1979
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1221 MAIN ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 204
	Group Practice or individual's line 2 address
City	WEYMOUTH
	Group Practice or individual's city
State	MA
	Group Practice or individual's state
Zip Code	021901563
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7813317075
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	220100
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SOUTH SHORE HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y