Individual provider Active NPI

Charlie Jijer Changchien, M.D.

  • Pediatrics Physician
  • Red Bank, NJ
National Provider Identifier
1265616908
Registry record updated Dec 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA08348300 Issued in NJ
Practice address
1 Riverview PLZ
Millennium Pediatric Care, Riverview Medical Center
Red Bank, NJ 07701-1864
Phone
(732) 450-2801
Fax
(732) 450-2802
NPI assigned
Dec 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2007

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 25MA08348300 NJ Primary

Addresses

Primary practice location

1 Riverview PLZ
Millennium Pediatric Care, Riverview Medical Center
Red Bank, NJ 07701-1864

Mailing address

1 Riverview PLZ
Millennium Pediatric Care, Riverview Medical Center
Red Bank, NJ 07701-1864
Phone (732) 450-2801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20180125002173 NJ Practitioner - Pediatric Medicine 9931474129 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08348300NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Primary Care PC Pediatrics CurrentSince Dec 10, 2017 Accepting new patients
Meridian Medical Group - Specialty Care, PC Pediatrics Past Accepting new patients
HMH Hospitals Corporation Past Accepting new patients

Locations

985 Cedar Bridge Ave
Brick, NJ 08723
Phone (732) 477-5600

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

3600 State Route 66
Fl 3
Neptune City, NJ 07753
Phone (732) 807-0463

300 Perrine Rd
Ste 324
Old Bridge, NJ 08857
Phone (732) 753-9890

1 Riverview Plz
Red Bank, NJ 07701
Phone (732) 530-2204

Interoperability endpoints

  • Direct secure messaging: charlie.changchien@direct.hackensackmeridian.org
  • FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/

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": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1265616908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RIVERVIEW PLZ",
            "address_2": "MILLENNIUM PEDIATRIC CARE, RIVERVIEW MEDICAL CENTER",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011864",
            "telephone_number": "732-450-2801",
            "fax_number": "732-450-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RIVERVIEW PLZ",
            "address_2": "MILLENNIUM PEDIATRIC CARE, RIVERVIEW MEDICAL CENTER",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011864",
            "telephone_number": "732-450-2801",
            "fax_number": "732-450-2802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANGCHIEN",
        "first_name": "CHARLIE",
        "middle_name": "JIJER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-18",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA08348300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, NJ

Sources for this page

Verify at the official NPI Registry.