Individual provider Active NPI

Kara Deaver Chang, M.D.

  • Specialist
  • Wellesley, MA
National Provider Identifier
1013941350
Registry record updated Mar 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
242142 Issued in MA
Practice address
30 Washington St
Wellesley, MA 02481-1905
Phone
(781) 263-0033
Fax
(781) 263-9125
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 036114321 IL
Specialist 174400000X 242142 MA Primary
Obstetrics & Gynecology Physician 207V00000X 242142 MA

Addresses

Primary practice location

30 Washington St
Wellesley, MA 02481-1905

Mailing address

30 Washington St
Wellesley, MA 02481-1905
Phone (781) 263-0033

Other identifiers 1

IdentifierTypeStateIssuer
01620273OtherILBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100309000231 MA Practitioner - Obstetrics/Gynecology 8820095474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Northwestern University Feinberg Medical School, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
About Women by Women a Professional CorporationGroup PAC ID 0749170306, 9 clinicians

Practice addresses (Care Compare)

30 Washington St
Wellesley, MA 02481-1929
Phone (781) 263-0033

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036114321ILMDSpecialist
242142MAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
About Women by Women a Professional Corporation Obstetrics & Gynecology CurrentSince Mar 1, 2010 Accepting new patients
Chicago Women'S Health Group at Northwestern Specialist Past Accepting new patients

Locations

30 Washington St
Wellesley Hills, MA 02481
Phone (781) 263-0033

Interoperability endpoints

  • Direct secure messaging: chang.kara.awbw@direct.partners.masshiway.net

Organizations & group practices 2

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300665600000",
    "number": "1013941350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 WASHINGTON ST",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024811905",
            "telephone_number": "781-263-0033",
            "fax_number": "781-263-9125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 WASHINGTON ST",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024811905",
            "telephone_number": "781-263-0033",
            "fax_number": "781-263-9125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAVER CHANG",
        "first_name": "KARA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2011-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036114321",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "242142",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "242142",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01620273",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley, MA

Sources for this page

Verify at the official NPI Registry.