Individual provider Active NPI

James Kenneth Chang, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Jersey City, NJ
National Provider Identifier
1053501916
Registry record updated Dec 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
25MA08717800 Issued in NJ
Practice address
3144 Kennedy Blvd
Jersey City, NJ 07306-3524
Phone
(201) 792-9339
Fax
(201) 792-9818
NPI assigned
Jul 26, 2007
Last updated
Dec 6, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 25MA08717800 NJ
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 254259 NY
Interventional Pain Medicine Physician 208VP0014X 254259 NY
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 25MA08717800 NJ Primary

Addresses

Primary practice location

3144 Kennedy Blvd
Jersey City, NJ 07306-3524

Mailing address

3144 Kennedy Blvd
Jersey City, NJ 07306-3524
Phone (201) 943-7670

Other practice location 1

605 Broad Ave Ste 201
Ridgefield, NJ 07657-1604
Phone (201) 943-7670

Other practice location 2

3077 Hylan Blvd
Staten Island, NY 10306-4113
Phone (201) 943-7670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20100909000798 NJ Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 7517082803 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
All Be Healthy LLCGroup PAC ID 1951796622, 94 clinicians

Practice addresses (Care Compare)

210 Mounts Corner Dr
Freehold, NJ 07728-2547
Phone (732) 724-2596

3144 Kennedy Blvd
Jersey City, NJ 07306-3524
Phone (201) 943-7670

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
254259NYMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
All Be Healthy LLC Pain Medicine CurrentSince Jan 24, 2023 Accepting new patients
All Be Healthy LLC Pain Medicine CurrentSince Jan 24, 2023 Accepting new patients
Old Bridge Spine & Wellness Center,PA Pain Medicine CurrentSince Feb 5, 2020 Accepting new patients
Kenneth S Chang MD PA PastSince Dec 9, 2019 Accepting new patients

Locations

1455 Broad St
Ste 250
Bloomfield, NJ 07003
Phone (201) 817-6982

150 Tices Ln
East Brunswick, NJ 08816
Phone (732) 254-5553

150A Tices Ln
East Brunswick, NJ 08816
Phone (732) 254-5553

2-22 Banta Pl
Fair Lawn, NJ 07410
Phone (201) 509-8600

210 Mounts Corner Dr
Freehold, NJ 07728
Phone (732) 333-6322

144 State Route 34
Matawan, NJ 07747
Phone (732) 316-5895

300 Perrine Rd
Ste 305
Old Bridge, NJ 08857
Phone (732) 316-5895

300 Perrine Rd
Ste 315
Old Bridge, NJ 08857
Phone (732) 264-8282

765 Route 10
Ste 101
Randolph, NJ 07869
Phone (973) 983-3709

525 State Route 35
Tinton Falls, NJ 07701
Phone (732) 747-6833

1311 Morris Ave
Union, NJ 07083
Phone (877) 532-3837

Organizations & group practices 6

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 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": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1053501916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3144 KENNEDY BLVD",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073063524",
            "telephone_number": "201-943-7670",
            "fax_number": "201-943-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3144 KENNEDY BLVD",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073063524",
            "telephone_number": "201-792-9339",
            "fax_number": "201-792-9818"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "605 Broad Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Ridgefield",
            "state": "NJ",
            "postal_code": "076571604",
            "country_code": "US",
            "telephone_number": "201-943-7670",
            "fax_number": "201-943-7675",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3077 Hylan Blvd",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103064113",
            "country_code": "US",
            "telephone_number": "201-943-7670",
            "fax_number": "201-943-7675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "JAMES",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-26",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NJ",
            "license": "25MA08717800",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NY",
            "license": "254259",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NY",
            "license": "254259",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NJ",
            "license": "25MA08717800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.