Individual provider Active NPI

Peter H Chang, DO

  • Pediatric Cardiology Physician
  • Portland, OR
National Provider Identifier
1003926189
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
DO26736 Issued in OR
Practice address
300 N Graham St Ste 250
Portland, OR 97227-1666
Phone
(503) 280-3418
Fax
(503) 284-7885
NPI assigned
Aug 30, 2006
Last updated
Sep 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X OP00002095 WA
Pediatric Cardiology Physician 2080P0202X DO26736 OR Primary

Addresses

Primary practice location

300 N Graham St Ste 250
Portland, OR 97227-1666

Mailing address

PO Box 821350
Vancouver, WA 98682-0030
Phone (360) 687-5221

Other practice location 1

1615 Delaware St
Longview, WA 98632-2367
Phone (360) 414-2385

Other identifiers 2

IdentifierTypeStateIssuer
213128MedicaidOR
1123090OtherWAMEDICAID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070108000185 OR Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 2860492378 Reassigns benefits to 11 organizations
I20110511000391 WA Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 2860492378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Nova Southeastern College of Osteo Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatric Cardiology Center of Oregon PCGroup PAC ID 7911978804, 5 clinicians

Practice addresses (Care Compare)

300 N Graham St
Suite 250
Portland, OR 97227-1666
Phone (503) 280-3418

9701 SW Barnes Rd
Suite 299
Portland, OR 97225-6689
Phone (503) 280-3418

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Valley Healthcare, Inc. CurrentSince May 1, 2019 Accepting new patients
Albany General Hospital Current Accepting new patients
Samaritan Pacific Health Services, Inc CurrentSince May 1, 2019 Accepting new patients
Samaritan Pacific Health Services, Inc. Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest Current Accepting new patients
Salem Health West Valley CurrentSince Mar 11, 2012 Accepting new patients
Salem Health CurrentSince Sep 1, 2012 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince May 2, 2014 Accepting new patients
Albany General Hospital CurrentSince May 1, 2019 Accepting new patients
Samaritan North Lincoln Hospital Current Accepting new patients
Samaritan North Lincoln Hospital CurrentSince May 1, 2019 Accepting new patients
Peacehealth Medical Group CurrentSince Sep 24, 2024 Accepting new patients
Salem Health CurrentSince Sep 1, 2012 Accepting new patients
Mid-Valley Healthcare Inc Current Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince May 1, 2019 Accepting new patients
Peacehealth CurrentSince Nov 6, 2024 Accepting new patients
Mid-Valley Healthcare Inc CurrentSince May 1, 2019 Accepting new patients
Samaritan Pacific Health Services, Inc Current Accepting new patients
Samaritan Pacific Health Services Inc CurrentSince May 1, 2019 Accepting new patients
Samaritan North Lincoln Hospital CurrentSince May 1, 2019 Accepting new patients
Albany General Hospital CurrentSince May 1, 2019 Accepting new patients
Peacehealth Medical Group CurrentSince Sep 24, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince May 2, 2014 Accepting new patients
Good Samaritan Hospital Corvallis Current Accepting new patients
Peacehealth Past Accepting new patients

Locations

705 Elm St SW
Ste 200
Albany, OR 97321
Phone (541) 812-4850

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

525 SE Washington St
Dallas, OR 97338
Phone (503) 623-7344

4010 Aerial Way
Eugene, OR 97402
Phone (541) 242-8300

1601 Monmouth St
Ste 100
Independence, OR 97351
Phone (503) 623-8301

325 Park St
Lebanon, OR 97355
Phone (541) 451-7200

3043 NE 28th St
Lincoln City, OR 97367
Phone (541) 994-3661

930 SW Abbey St
Newport, OR 97365
Phone (541) 265-2244

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

3377 Riverbend Dr
Ste 410
Springfield, OR 97477

1615 Delaware St
Longview, WA 98632
Phone (360) 363-4818

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GIEBDD/Endpoint/GIEBDD
  • Direct secure messaging: peter.chang@pcco.eclinicaldirectplus.com

Organizations & group practices 26

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1003926189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 821350",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986820030",
            "telephone_number": "360-687-5221",
            "fax_number": "360-666-0466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N GRAHAM ST STE 250",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271666",
            "telephone_number": "503-280-3418",
            "fax_number": "503-284-7885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1615 Delaware St",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "WA",
            "postal_code": "986322367",
            "country_code": "US",
            "telephone_number": "360-414-2385",
            "fax_number": "360-414-2386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "PETER",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "WA",
            "license": "OP00002095",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "OR",
            "license": "DO26736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213128",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "1123090",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.