Jason Victor Chang, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

036-127321 Issued in IL

Practice address

1701 E Woodfield Road
Suite 1000
Schaumburg, IL 60173-5113

Phone

(847) 240-2211

Fax

(847) 240-2418

NPI assigned

Aug 2, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, FL2 enrollments

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 2

Specialty

Psychiatry

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pra Behavioral LLCGroup PAC ID 3274427729, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jason.chang.p27@direct.gapho.nextgenshare.com

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.

• Pra Behavioral LLC

  • Mental Health Counselor
  • Schaumburg, IL
  • NPI 1679546873
  Medicare reassignment Care Compare group
• Lakeland Regional Health Systems, Inc.

  • Multi-Specialty Clinic/Center
  • Lakeland, FL
  • NPI 1497748743

  Psychiatry

  Medicare reassignment NPD

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

{
    "created_epoch": "1217635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1124284708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 E WOODFIELD ROAD",
            "address_2": "SUITE 1000",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601735113",
            "telephone_number": "847-240-2211",
            "fax_number": "847-240-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E WOODFIELD ROAD",
            "address_2": "SUITE 1000",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601735113",
            "telephone_number": "847-240-2211",
            "fax_number": "847-240-2418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 Doctors Park",
            "address_purpose": "LOCATION",
            "city": "Gibson City",
            "state": "IL",
            "postal_code": "609362000",
            "country_code": "US",
            "telephone_number": "217-784-4540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "JASON",
        "middle_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-02",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "125-054734",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036-127321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "1633897",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jason.chang.p27@direct.gapho.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4 Doctors Park",
            "city": "Gibson City",
            "state": "IL",
            "country_code": "US",
            "postal_code": "609362000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Center for Seniors
• Centered Village LLC
• CH MH Services (Il), LLC
• Christeena Chakkumcal
• Erica Chandler, CPO
• Stephanie Jane Abila Chanitthikul
• Chang Chao, LAC
• Mallory Charatz
• Charles Goodsite and Thomas Seretis LTD.
• Robert Chatterton

• Child & Adolescent Psychiatry Physician in Schaumburg, IL
• Providers in Schaumburg, IL by specialty
• Child & Adolescent Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.