NPIMap

Individual provider Active NPI

Elbert KC Chang, MD

  • Pulmonary Disease Physician
  • Montclair, CA
National Provider Identifier
1053417808
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
A89864 Issued in CA
Practice address
9525 Monte Vista Ave Ste 105
Montclair, CA 91763-2231
Phone
(909) 626-1205
NPI assigned
Sep 16, 2006
Last updated
Aug 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X A89864 CA Primary

Addresses

Primary practice location

9525 Monte Vista Ave Ste 105
Montclair, CA 91763-2231

Mailing address

9525 Monte Vista Ave Ste 105
Montclair, CA 91763-2231
Phone (909) 626-1205

Other identifiers 1

IdentifierTypeStateIssuer
00A898640MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050124001105 CA Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 7517917958 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inland Physicians Pulmonary ServicesGroup PAC ID 4981008760, 7 clinicians
Inland Physicians Hospitalist ServicesGroup PAC ID 5294135612, 14 clinicians

Practice addresses (Care Compare)

255 E Bonita Ave
Pomona, CA 91767-1923
Phone (909) 626-1205

999 San Bernardino Rd
Upland, CA 91786-4920
Phone (909) 985-2811

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
89864CAMDPharmacist
A89864CAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Pulmonary Medical Group Pulmonary Disease CurrentSince Feb 1, 2005 Accepting new patients
Inland Physicians Primary Care Services Current Accepting new patients
Inland Physicians Hospitalist Services CurrentSince May 1, 2021 Accepting new patients
Inland Physicians Pulmonary Services Pulmonary Disease CurrentSince Jun 1, 2021 Accepting new patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients
Primecare Medical Group Past Accepting new patients
Diagnostic Imaging Services Past Accepting new patients
Prime Healthcare Services - Montclair, LLC Past Accepting new patients

Locations

5451 Walnut Ave
Chino, CA 91710
Phone (909) 464-8600

5000 San Bernardino St
Montclair, CA 91763
Phone (909) 625-4111

9525 Monte Vista Ave
Unit 105
Montclair, CA 91763
Phone (909) 626-1205

9655 Monte Vista Ave
#402
Montclair, CA 91763
Phone (909) 625-1977

9655 Monte Vista Ave
Ste 402
Montclair, CA 91763
Phone (909) 591-6575

1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810

255 E Bonita Ave
Pomona, CA 91767
Phone (866) 724-4127

1113 Alta Ave
Ste 220
Upland, CA 91786
Phone (909) 985-1908

637 N 13th Ave
Upland, CA 91786
Phone (909) 625-1977

999 San Bernardino Rd
Upland, CA 91786
Phone (909) 920-4841

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: casacolina@direct.casacolina.org
  • Direct secure messaging: e.chang@ipmg.directbygreenway.com

Organizations & group practices 8

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.

Hospital & facility affiliations 6

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1053417808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9525 MONTE VISTA AVE STE 105",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632231",
            "telephone_number": "909-626-1205",
            "fax_number": "909-625-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9525 MONTE VISTA AVE STE 105",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632231",
            "telephone_number": "909-626-1205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "ELBERT",
        "middle_name": "KC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A89864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A898640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, CA

Sources for this page

Verify at the official NPI Registry.