Individual provider Active NPI

Justin P. Chang, M.D.

  • Diagnostic Radiology Physician
  • Indianapolis, IN
National Provider Identifier
1174722649
Registry record updated Dec 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036130090 Issued in IL
Practice address
9998 Crosspoint Blvd Ste 200
Indianapolis, IN 46256-3307
Phone
(317) 579-2150
Fax
(317) 579-2130
NPI assigned
Jul 16, 2007
Last updated
Dec 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 01073035A IN
Diagnostic Radiology Physician 2085R0202X 99057727A IN
Diagnostic Radiology Physician 2085R0202X 036130090 IL Primary

Addresses

Primary practice location

9998 Crosspoint Blvd Ste 200
Indianapolis, IN 46256-3307

Mailing address

9998 Crosspoint Blvd Ste 200
Indianapolis, IN 46256-3307
Phone (317) 579-2150

Other identifiers 1

IdentifierTypeStateIssuer
201200960MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20130805000242 IN Practitioner - Diagnostic Radiology 9537301577 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Toledo Medical College, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Decatur County Memorial HospitalGroup PAC ID 7315837671, 128 clinicians
Radiology of Indiana P CGroup PAC ID 0648161430, 122 clinicians

Practice addresses (Care Compare)

720 N Lincoln St
Greensburg, IN 47240-1327
Phone (812) 663-4331

9998 Crosspoint Blvd
Suite 200
Indianapolis, IN 46256-3307
Phone (317) 579-2150

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036130090ILMDDiagnostic Radiology Physician
01073035AINMDDiagnostic Radiology Physician
99057727AINMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Decatur County Memorial Hospital CurrentSince Jan 1, 2025 Accepting new patients
Decatur County Memorial Hospital CurrentSince May 1, 2025 Accepting new patients
Decatur County Memorial Hospital CurrentSince Jan 1, 2025 Accepting new patients
Radiology of Indiana P C Diagnostic Radiology CurrentSince Nov 15, 2014 Accepting new patients
Hancock Health Gateway Services, Inc. Past Accepting new patients

Locations

26 Six Pine Ranch Rd
Batesville, IN 47006
Phone (812) 934-5252

720 N Lincoln St
Greensburg, IN 47240
Phone (812) 522-2349

7340 Shadeland Sta
Ste 200
Indianapolis, IN 46256

9998 Crosspoint Blvd
Ste 200
Indianapolis, IN 46256

Interoperability endpoints

  • Direct secure messaging: jchang190697@direct.franciscanalliance.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608768000000",
    "number": "1174722649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9998 CROSSPOINT BLVD STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462563307",
            "telephone_number": "317-579-2150",
            "fax_number": "317-579-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9998 CROSSPOINT BLVD STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462563307",
            "telephone_number": "317-579-2150",
            "fax_number": "317-579-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "JUSTIN",
        "middle_name": "P.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-16",
        "last_updated": "2020-12-24",
        "certification_date": "2020-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01073035A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "99057727A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036130090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201200960",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.