Kaliq Trimble Chang, MD

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

270617 Issued in NY

Practice address

475 Prospect Ave
Ste 110
West Orange, NJ 07052

Phone

(973) 419-0200

NPI assigned

Apr 28, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2016 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HABCDA/Endpoint/HABCDA

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1013151471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 PROSPECT AVE",
            "address_2": "STE 110",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "07052",
            "telephone_number": "973-419-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 PROSPECT AVE",
            "address_2": "STE 110",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "07052",
            "telephone_number": "973-419-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "KALIQ",
        "middle_name": "TRIMBLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-28",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "270617",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NY",
            "license": "270617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Izzat Chaaban, PT, DPT
• Chaman Preet Singh Chahal, M.D.
• Elie Youssef Chakhtoura, M.D.
• Katherine Fair Chan, PH.D.
• Yi Hung Chan, DPM
• Patrick Kung Sun Chang, M.D.
• Peiyun Chang, D.O.
• Charles M Cummins, OD, PA
• Sylvester Chastanet, LPC
• Tule Anita Chau, LCSW

• Pain Medicine (Anesthesiology) Physician in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Pain Medicine (Anesthesiology) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.