Individual provider Active NPI

Mariana Chang, MD

  • Nephrology Physician
  • Brooklyn, NY
National Provider Identifier
1235691205
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
329246 Issued in NY
Practice address
577 Prospect Ave Apt 1B
Brooklyn, NY 11215-6074
Phone
(718) 369-0318
Fax
(718) 369-0290
NPI assigned
Apr 1, 2019
Last updated
Oct 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 329246 NY Primary

Addresses

Primary practice location

577 Prospect Ave Apt 1B
Brooklyn, NY 11215-6074

Mailing address

1 Hospital PLZ
Stamford, CT 06902-3602
Phone (203) 276-7147

Other identifiers 2

IdentifierTypeStateIssuer
A400358353OtherNYMEDICARE
07909497MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240722000732 NY Practitioner - NephrologyPractitioner - Internal Medicine 6507302056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kidney Care of Brooklyn and Queens PLLCGroup PAC ID 3072747237, 4 clinicians

Practice addresses (Care Compare)

1402 Atlantic Ave
Brooklyn, NY 11216-2812
Phone (718) 369-0318

1530 Bedford Ave
Brooklyn, NY 11216-4117
Phone (718) 369-0318

358 4TH Ave
Brooklyn, NY 11215-2718
Phone (718) 369-0318

577 Prospect Ave
Apt 1B
Brooklyn, NY 11215-6074
Phone (718) 369-0318

595 Degraw St
Brooklyn, NY 11217-3120
Phone (718) 369-0318

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney Care of Brooklyn and Queens, PLLC Nephrology CurrentSince Jul 1, 2024 Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients

Locations

1530 Bedford Ave
Brooklyn, NY 11216
Phone (718) 221-2020

1530 Bedford Ave
#3
Brooklyn, NY 11216
Phone (718) 774-1524

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: mac9758@direct.weillcornell.org

Organizations & group practices 2

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 5

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": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1235691205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL PLZ",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023602",
            "telephone_number": "203-276-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 PROSPECT AVE APT 1B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112156074",
            "telephone_number": "718-369-0318",
            "fax_number": "718-369-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "MARIANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "329246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "A400358353",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07909497",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.