MATTHEW NAN FAN (MD) – Psychiatry Physician, NPI 1063777860

MATTHEW NAN FAN (MD) is a healthcare provider. based in Fort worth, Texas. specializing in PSYCHIATRY. They hold the professional credentials MD. They hold a License No. 44743 (TX). The NPI Number for MATTHEW NAN FAN (MD) is 1063777860

Main info

Male
18 Years Of Experience
Accepts Medicare Assignment
Name
MATTHEW NAN FAN (MD)
NPI
1063777860
Phone
Not provided
Address
PO BOX 99335
Enumeration Date
8 July 2012
Last Update Date
2 March 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9173910076
Graduation Year
2008 (18 years ago)
PAC ID
1658341839
Group Practice PAC ID
9931595576
Professional Enrollment ID
I20220420002109
Address ID
NY100160942NE353XXAVEX302
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:13State licenses:2Digital endpointsOther names

2,132 PSYCHIATRY in TX

Provider Addresses for MATTHEW NAN FAN (MD)

  • PO BOX 99335

    FORT WORTH, TX 761990335

    Phone:

    Type: Mailing

  • 855 MONTGOMERY ST

    FORT WORTH, TX 761072553

    Phone: (817) 735-2400

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 19 Open Payments records for all available years, with a total value of $373.

Total Amount is formed as General ($373) + Research ($0) + Ownership ($0) = $373.

Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Alkermes, Inc. ($161).

Total Amount

$373

General + Research + Ownership

Payments

19

Total payment records

General Amount

$373

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-18

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-04-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220420002109IPsychiatryNYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 76199)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9931595576View full group profile
NameSpecialtyState
P S Y C H I A T R YCT
Psychiatry, NeuropsychiatryMN
Physician AssistantNY
P S Y C H I A T R YNY
Clinical Social WorkerNJ
P S Y C H I A T R YIA
P S Y C H I A T R YNJ
P S Y C H I A T R YNY

Reviews

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Frequently asked questions

Can I verify MATTHEW NAN FAN (MD) with an NPI only?
You can start verification with NPI 1063777860 for MATTHEW NAN FAN (MD), then check state licensing separately.
Is MATTHEW NAN FAN (MD) listed as active for patients and plans?
The listing shows MATTHEW NAN FAN (MD) as active in the NPI system.
What is MATTHEW NAN FAN (MD)'s primary classification?
Psychiatry Physician is the headline specialty for MATTHEW NAN FAN (MD) here. Clinical services aligned with this taxonomy classification.
Where is MATTHEW NAN FAN (MD) based?
MATTHEW NAN FAN (MD) is tied to Fort Worth, Texas in the data we show; additional addresses may exist on the full record.
Is the information about MATTHEW NAN FAN (MD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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