Individual provider Active NPI

Theresa S Chang, MD

  • Anesthesiology Physician
  • Boston, MA
National Provider Identifier
1013976547
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
223302 Issued in MA
Practice address
55 Fruit St
Cln309 Anesthesia Associates
Boston, MA 02114-2696
Phone
(617) 726-3030
NPI assigned
Mar 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 223302 MA Primary

Addresses

Primary practice location

55 Fruit St
Cln309 Anesthesia Associates
Boston, MA 02114-2696

Mailing address

PO Box 9142
Mass General Physician Organization
Charlestown, MA 02129-9142
Phone (617) 724-0287

Other identifiers 3

IdentifierTypeStateIssuer
2104491MedicaidMA
478709OtherMATUFTS HEALTH PLAN
J28954OtherMABCBS MA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070628000331 CA Practitioner - Anesthesiology 9638109325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Northwestern University Feinberg Medical School, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Care Associates Medical Group, IncGroup PAC ID 1850334384, 108 clinicians

Practice addresses (Care Compare)

1 Daniel Burnham CT
Apt 205
San Francisco, CA 94109-5456
Phone (441) 221-7056

1101 Van Ness Ave
San Francisco, CA 94109-6919
Phone (415) 600-6000

1501 Trousdale Dr
Burlingame, CA 94010-4506
Phone (650) 696-5400

180 Rowland Way
Novato, CA 94945-5009
Phone (415) 209-1300

Hospital & facility affiliations

  • California Pacific Medical Center- Van Ness Campus Hospital, San Francisco, CA, CCN 050047
  • Novato Community Hospital Hospital, Novato, CA, CCN 050131
  • California Pacific Medical Center - Mission Bernal Hospital, San Francisco, CA, CCN 050055
  • California Pacific Medical Ctr-Davies Campus Hosp Hospital, San Francisco, CA, CCN 050008
  • Sutter Santa Rosa Regional Hospital Hospital, Santa Rosa, CA, CCN 050291

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Care Associates Medical Group Inc Anesthesiology CurrentSince Jan 1, 2020 Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients

Locations

1501 Trousdale Dr
Burlingame, CA 94010
Phone (650) 696-3520

180 Rowland Way
Novato, CA 94945
Phone (415) 209-1300

2333 Buchanan St
San Francisco, CA 94115
Phone (415) 563-4321

77 Van Ness Ave
Apt 301
San Francisco, CA 94102
Phone (415) 821-8015

3555 Cesar Chavez
San Francisco, CA 94110
Phone (415) 485-8824

55 Francisco St
Ste 500
San Francisco, CA 94133
Phone (415) 834-3000

1635 Divisadero St
Ste 200
San Francisco, CA 94115
Phone (415) 346-1218

3000 California St
#2
San Francisco, CA 94115
Phone (415) 561-1171

Interoperability endpoints

  • Direct secure messaging: tchang183559@hisp.ehr.sutterhealth.org

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 5

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": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013976547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9142",
            "address_2": "MASS GENERAL PHYSICIAN ORGANIZATION",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021299142",
            "telephone_number": "617-724-0287",
            "fax_number": "617-726-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "CLN309 ANESTHESIA ASSOCIATES",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-726-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "THERESA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "223302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2104491",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "478709",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J28954",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.