Beverly Chang MD, Inc

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A118995 Issued in CA

Legal business name

BEVERLY CHANG MD, INC

Practice address

1700 Eureka Rd Ste 140a
Roseville, CA 95661-7720

Phone

(916) 303-4353

Fax

(916) 303-4356

NPI assigned

Jan 4, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Beverly Anne ChangNPI 1063716009

Title

Owner

Phone

(916) 303-4353

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Beverly Anne Chang, MD

  • Geriatric Psychiatry Physician
  • San Diego, CA
  • NPI 1063716009

  CA

  Medicare reassignment NPD Authorized official
• Bethany Rae Newman, NP

  • Geriatric Psychiatry Physician
  • Roseville, CA
  • NPI 1982583399
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1451865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659484800000",
    "number": "1003272287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 E ROSEVILLE PKWY STE 140-313",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 EUREKA RD STE 140A",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956617720",
            "telephone_number": "916-303-4353",
            "fax_number": "916-303-4356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY CHANG MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-04",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-303-4353"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A118995",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "CA",
            "license": "A118995",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Best Physical Therapy and Wellness, Inc.
• Best Physical Therapy and Wellness, Inc.
• Best Physical Therapy and Wellness, Inc.
• David Michael Bettencourt
• John Jay E Betz, MD
• Sean William Bezdek, MFT
• Aditi Bhaduri, M.D.
• Megha Bhalla
• Adarsh Bhat, M.D.
• Anupama Savithri Bhat, MD

• All providers in Roseville, CA
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.