Individual provider Active NPI

Joan Chyong-Wen Chang, DO

  • Geriatric Medicine (Internal Medicine) Physician
  • Indianapolis, IN
National Provider Identifier
1063526291
Registry record updated Oct 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
02004731A Issued in IN
Practice address
8424 Naab Rd Ste 1L
Indianapolis, IN 46260-1954
Phone
(317) 338-7780
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 253044 NY
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 02004731A IN Primary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 02004731A IN
Internal Medicine Physician 207R00000X 02004731A IN

Addresses

Primary practice location

8424 Naab Rd Ste 1L
Indianapolis, IN 46260-1954

Mailing address

8840 Commerce Park PL Ste E
Indianapolis, IN 46268-3129

Other identifiers 2

IdentifierTypeStateIssuer
0415706OtherNYINDEPENDENT HEALTH
03111199MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240808001233 NY Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9830197714

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Waterfront Operations Associates LLC Past Accepting new patients
Delaware Operations Assoc LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jchang@landmarkhealth-direct.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.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443744000000",
    "number": "1063526291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8840 COMMERCE PARK PL STE E",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462683129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8424 NAAB RD STE 1L",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601954",
            "telephone_number": "317-338-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "JOAN",
        "middle_name": "CHYONG-WEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2015-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "253044",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IN",
            "license": "02004731A",
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "IN",
            "license": "02004731A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "02004731A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "0415706",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03111199",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.