Yi Catherine Chang, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

50785 Issued in MN

Practice address

11107 Ulysses St NE
Blaine, MN 55434-4263

Phone

(763) 333-7733

Fax

(763) 333-7711

NPI assigned

Aug 10, 2007

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Child and Teen Medical Center

  • Pediatrics Physician
  • Blaine, MN
  • NPI 1225158520
  NPD

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1033301452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11107 ULYSSES ST NE STE 100",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554344264",
            "telephone_number": "763-333-7733",
            "fax_number": "763-333-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11107 ULYSSES ST NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554344263",
            "telephone_number": "763-333-7733",
            "fax_number": "763-333-7711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12200 Middle Set Rd",
            "address_2": "Suite #100",
            "address_purpose": "LOCATION",
            "city": "Eden Prairie",
            "state": "MN",
            "postal_code": "553445415",
            "country_code": "US",
            "telephone_number": "952-943-8200",
            "fax_number": "952-943-8206",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7225 University Ave NE",
            "address_purpose": "LOCATION",
            "city": "Fridley",
            "state": "MN",
            "postal_code": "554323134",
            "country_code": "US",
            "telephone_number": "763-333-7733",
            "fax_number": "763-333-7711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "YI",
        "middle_name": "CATHERINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-10",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "50785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca J Cebuhar, PHARMD
• Center for Mental Health and Wellness, LLC
• Andrew Thomas Chadbourn, DMD
• Paul Wayne Chadbourn, D.D.S.
• Sherman CHI-Man Chan, DC
• Daniel P Chaves, DC
• Dumah Chebo, RN
• Yingying Chen
• Irene CHI
• Child and Teen Medical Center

• Pediatrics Physician in Blaine, MN
• Providers in Blaine, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.