NPIMap

Individual provider Active NPI

Susan S. Chang, MD

  • Nephrology Physician
  • Camarillo, CA
National Provider Identifier
1073673273
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A61663 Issued in CA
Practice address
2438 N Ponderosa Dr
Suite # C-101
Camarillo, CA 93010-2369
Phone
(805) 383-9727
Fax
(805) 764-1076
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A61663 CA Primary

Addresses

Primary practice location

2438 N Ponderosa Dr
Suite # C-101
Camarillo, CA 93010-2369

Mailing address

4000 Calle Tecate Ste 115
Camarillo, CA 93012-5285
Phone (805) 485-2400

Other practice location 1

2705 Loma Vista Rd Ste 101
Ventura, CA 93003-1596
Phone (805) 383-9727

Other identifiers 1

IdentifierTypeStateIssuer
00A616630MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address susan.chang@ventura.cernerdirect.com Direct

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
I20071127000777 CA Practitioner - NephrologyPractitioner - Internal Medicine 7517056641 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of Colorado School of Medicine, Denver, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Renal Consultants of Ventura County IncGroup PAC ID 1658595590, 9 clinicians

Practice addresses (Care Compare)

2438 N Ponderosa Dr
Suite C101
Camarillo, CA 93010-2465
Phone (805) 383-9727

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A61663CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Ventura CurrentSince Nov 16, 2007 Accepting new patients
Renal Consultants of Ventura County, Inc Nephrology CurrentSince Jul 1, 2014 Accepting new patients
County of Ventura Current Accepting new patients
County of Ventura CurrentSince Nov 16, 2007 Accepting new patients
Community Memorial Health System Past Accepting new patients
Vista del Mar Medical Group, Inc Nephrology Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

4000 Calle Tecate
Ste 115
Camarillo, CA 93012
Phone (805) 485-2400

2438 N Ponderosa Dr
Ste C101
Camarillo, CA 93010
Phone (559) 664-9252

3541 W 5th St
Oxnard, CA 93030
Phone (805) 984-5435

2240 E Gonzales Rd
Ste 100
Oxnard, CA 93036
Phone (805) 981-5151

2240 E Gonzales Rd
Ste 110
Oxnard, CA 93036
Phone (805) 961-5161

1900 Outlet Center Dr
Oxnard, CA 93036
Phone (805) 278-3815

14860 Roscoe Blvd
Ste 101
Panorama City, CA 91402
Phone (818) 709-4827

2705 Loma Vista Rd
Ste 101
Ventura, CA 93003
Phone (805) 383-9727

300 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-6000

2125 Knoll Dr
Ste 104
Ventura, CA 93003

800 S Victoria Ave
#L4640
Ventura, CA 93009

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FCFGBD
  • FHIR API: https://fhir4.healow.com/fhir/r4/FBCJAD
  • Direct secure messaging: susan.chang@ventura.cernerdirect.com

Organizations & group practices 7

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 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1073673273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 CALLE TECATE STE 115",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125285",
            "telephone_number": "805-485-2400",
            "fax_number": "805-233-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2438 N PONDEROSA DR",
            "address_2": "SUITE # C-101",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102369",
            "telephone_number": "805-383-9727",
            "fax_number": "805-764-1076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2705 Loma Vista Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930031596",
            "country_code": "US",
            "telephone_number": "805-383-9727",
            "fax_number": "805-764-0176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "SUSAN",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A61663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A616630",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "susan.chang@ventura.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Cerner Direct Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Information",
            "address_1": "2705 Loma Vista Rd Ste 101",
            "city": "Ventura",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930031596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

Verify at the official NPI Registry.