NPIMap

Individual provider Active NPI

Tien-Lan Chang, MD

  • Pediatrics Physician
  • Malden, MA
National Provider Identifier
1255313771
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
53617 Issued in MA
Practice address
105 Commercial St
Malden, MA 02148-5509
Phone
(781) 322-5101
Fax
(781) 322-5820
NPI assigned
Nov 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 53617 MA Primary

Addresses

Primary practice location

105 Commercial St
Malden, MA 02148-5509

Mailing address

105 Commercial St
Malden, MA 02148-5509
Phone (781) 322-5101

Other identifiers 3

IdentifierTypeStateIssuer
3024253MedicaidMA
710885OtherMATUFTS HEALTH PLAN
J06703OtherMABCBS MA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53617MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Melrosewakefield Healthcare, Inc. Past Accepting new patients
Pediatric Associates of Malden, PC Pediatrics Past Accepting new patients
Pediatric Associates of Malden PC Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tchang8034@direct.chppoc.masshiway.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217808000000",
    "number": "1255313771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 COMMERCIAL ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485509",
            "telephone_number": "781-322-5101",
            "fax_number": "781-322-5820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 COMMERCIAL ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485509",
            "telephone_number": "781-322-5101",
            "fax_number": "781-322-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "TIEN-LAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2008-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "53617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3024253",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "710885",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J06703",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Malden, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; 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.