Individual provider Active NPI

Jeannie Chia Hui Chang, PA-C, MPAS

  • Physician Assistant
  • Sammamish, WA
National Provider Identifier
1114088713
Registry record updated May 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10005195 Issued in WA
Practice address
22707 SE 29TH St
Sammamish, WA 98075-9532
Phone
(425) 455-2845
Fax
(425) 861-8602
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X PA18135 CA
Physician Assistant 363A00000X PA10005195 WA Primary

Addresses

Primary practice location

22707 SE 29TH St
Sammamish, WA 98075-9532

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080929000242 WA Practitioner - Physician Assistant 3971670225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Utah School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Swedish Health ServicesGroup PAC ID 9537072814, 384 clinicians

Practice addresses (Care Compare)

2450 33Rd Ave W
Suite 100
Seattle, WA 98199-3252
Phone (206) 320-3364

911 N 10TH PL
Renton, WA 98057-0009
Phone (425) 391-5700

Hospital & facility affiliations

  • Swedish Medical Center / Cherry Hill Hospital, Seattle, WA, CCN 500025
  • Swedish Issaquah Hospital, Issaquah, WA, CCN 500152

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA18135CAMDFamily Medicine Physician
PA10005195WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services Family Medicine CurrentSince May 1, 2015 Accepting new patients

Locations

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

911 N 10th Pl
Renton, WA 98057
Phone (425) 391-5700

22707 SE 29th St
Sammamish, WA 98075
Phone (425) 455-2845

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

800 5th Ave
Ste 600
Seattle, WA 98104

Interoperability endpoints

  • Direct secure messaging: jchang1041288@wm.providencedirect.org

Organizations & group practices 1

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 2

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432857600000",
    "number": "1114088713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22707 SE 29TH ST",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980759532",
            "telephone_number": "425-455-2845",
            "fax_number": "425-861-8602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "JEANNIE",
        "middle_name": "CHIA HUI",
        "name_prefix": "Ms.",
        "credential": "PA-C, MPAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2015-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "PA18135",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10005195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sammamish, WA

Sources for this page

Verify at the official NPI Registry.