Organization Active NPI

John B. Chang,MDPC

  • Vascular Surgery Physician
  • Roslyn, NY
National Provider Identifier
1154307262
Registry record updated Mar 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
JOHN B. CHANG,MDPC
Practice address
1050 Northern Blvd
Roslyn, NY 11576-1503
Phone
(516) 484-3430
Fax
(516) 484-3482
NPI assigned
Dec 20, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2010

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

Authorized official

Name
Dr. Lucy Chang, MD
Title
Vice-President
Phone
(516) 484-3430

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

1050 Northern Blvd
Roslyn, NY 11576-1503

Mailing address

1050 Northern Blvd
Roslyn, NY 11576-1503
Phone (516) 484-3430

Other identifiers 1

IdentifierTypeStateIssuer
CJ8878OtherNYRAILROAD MEDICARE

Other names 1

  • D/B/A Long Island Vascular Center Doing business as

National Provider Directory

National Provider Directory

Locations

1050 Northern Blvd
Roslyn, NY 11576
Phone (516) 484-3430

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268006400000",
    "number": "1154307262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 NORTHERN BLVD",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761503",
            "telephone_number": "516-484-3430",
            "fax_number": "516-484-3482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 NORTHERN BLVD",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761503",
            "telephone_number": "516-484-3430",
            "fax_number": "516-484-3482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN B. CHANG,MDPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-20",
        "last_updated": "2010-03-08",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "LUCY",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "516-484-3430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD  MEDICARE",
            "identifier": "CJ8878",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "D/B/A Long Island Vascular Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roslyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.