Individual provider Active NPI

Michael S. Chang, M.D.

  • Diagnostic Radiology Physician
  • Redmond, WA
National Provider Identifier
1114074390
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD00043596 Issued in WA
Practice address
2700 152ND Ave NE
Redmond, WA 98052-5543
Phone
(425) 883-5151
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD00043596 WA Primary

Addresses

Primary practice location

2700 152ND Ave NE
Redmond, WA 98052-5543

Mailing address

PO Box 34581
Seattle, WA 98124-1581
Phone (509) 241-7349

Other practice location 1

11511 NE 10th St
Bellevue, WA 98004-8578
Phone (425) 502-3000

Other identifiers 2

IdentifierTypeStateIssuer
P00734158OtherWARAILROAD MEDICARE
8461121MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20070731000661 WA Practitioner - Diagnostic Radiology 6709977002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of California, San Francisco School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11511 NE 10TH St
Bellevue, WA 98004-8578
Phone (425) 502-3000

Hospital & facility affiliations

  • Kaiser Permanente Central Hospital Hospital, Seattle, WA, CCN 500052

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00043596WAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Feb 7, 2006 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Feb 7, 2006 Accepting new patients

Locations

11511 NE 10th St
Hunts Point, WA 98004
Phone (425) 502-3000

14701 179th Ave SE
Monroe, WA 98272
Phone (360) 794-1409

19379 7th Ave NE
Poulsbo, WA 98370
Phone (360) 394-1000

2700 152nd Ave NE
Redmond, WA 98052
Phone (425) 838-5151

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

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.

Hospital & facility affiliations 3

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1114074390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34581",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241581",
            "telephone_number": "509-241-7349",
            "fax_number": "509-241-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 152ND AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525543",
            "telephone_number": "425-883-5151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11511 NE 10th St",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980048578",
            "country_code": "US",
            "telephone_number": "425-502-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "MICHAEL",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD00043596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00734158",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8461121",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "11511 NE 10th St",
            "city": "Bellevue",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980048578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

Verify at the official NPI Registry.