Active NPI
Joan Chyong-Wen Chang, DO
- Geriatric Medicine (Internal Medicine) Physician
- Indianapolis, IN
National Provider Identifier
1063526291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- 02004731A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0415706 | Other | NY | INDEPENDENT HEALTH |
| 03111199 | Medicaid | NY |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240808001233 | NY | Order and Referring Only - Internal Medicine | 9830197714 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Waterfront Operations Associates LLC | Past | Accepting new patients | |
| Delaware Operations Assoc LLC | Past | Accepting new patients |
Interoperability endpoints
- 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.
-
dba Buffalo Center For Rehabiltation and Healthcare
- Skilled Nursing Facility
- Buffalo, NY
- NPI 1689055295
-
dba Ellicott Center for Rehabilitation and Nursing
- Skilled Nursing Facility
- Buffalo, NY
- NPI 1477833309
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.