Amy Chang, MD
Individual provider Active NPI Pediatrics Physician · Hockessin, DE
NPI 1124032750 · NPPES record last updated Jan 10, 2011
Key facts
- NPI
- 1124032750
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- C1-0006480 (DE)
- Practice address
- 722 Yorklyn Rd
Stone Mill Office Park, Suite 100
Hockessin, DE 19707 - Phone
- (302) 235-1188
- Fax
- (302) 239-2604
- NPI assigned
- Jul 28, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040715000724 | DE | Practitioner - Pediatric Medicine | 9335128115 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C1-0006480 | DE | MD | Pediatrics Physician |
| 25-MA-07452300 | NJ | MD | Pediatrics Physician |
| MD-423599 | PA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advocare , LLC | Current |
Accepting new patients | |
| Advocare, LLC | Pediatrics | Current |
Accepting new patients |
| Advocare, LLC | Pediatrics | Past | Accepting new patients |
Locations
3521 Silverside Rd
Ste 1F
Wilmington, DE 19810
Phone (302) 478-2613
401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033
Interoperability endpoints
- amy.chang.3@17596.direct.athenahealth.com
- amy.chang@advocaredoctors.eclinicaldirectplus.com
- https://api.platform.athenahealth.com/17596/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | C1-0006480 | DE | Yes |
| Pediatrics Physician | 208000000X | 25-MA-07452300 | NJ | |
| Pediatrics Physician | 208000000X | MD-423599 | PA |
Addresses
Primary practice location
722 Yorklyn Rd
Stone Mill Office Park, Suite 100
Hockessin, DE 19707
Mailing address
722 Yorklyn Rd
Stone Mill Office Park, Suite 100
Hockessin, DE 19707
Phone (302) 235-1188
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1012338790001 | Medicaid | PA |
NPI Registry JSON
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294617600000",
"number": "1124032750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "722 YORKLYN RD",
"address_2": "STONE MILL OFFICE PARK, SUITE 100",
"city": "HOCKESSIN",
"state": "DE",
"postal_code": "19707",
"telephone_number": "302-235-1188",
"fax_number": "302-239-2604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "722 YORKLYN RD",
"address_2": "STONE MILL OFFICE PARK, SUITE 100",
"city": "HOCKESSIN",
"state": "DE",
"postal_code": "19707",
"telephone_number": "302-235-1188",
"fax_number": "302-239-2604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "AMY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-28",
"last_updated": "2011-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "DE",
"license": "C1-0006480",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "25-MA-07452300",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD-423599",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1012338790001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hockessin, DE
- Katherine Castellon
- Emily Castro-Silvestre
- Susan Elaine Catalan
- Jintu Chacko
- Chadley Inc
- Amanda Chau Yue
- Mona Chaudhary
- Children and Families First
- Children'S Hospital of Philadelphia
- Raja Shekar Reddy Chirra
All providers in Hockessin, DE · Pediatrics Physician in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.