NPIMap

Individual provider Active NPI

Lyndon Chang, MD

  • Specialist
  • San Diego, CA
National Provider Identifier
1275593261
Registry record updated Aug 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
192851 Issued in NY
Practice address
4910 Directors PL Ste 150
San Diego, CA 92121-3801
Phone
(855) 360-6730
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 192851 NY Primary

Addresses

Primary practice location

4910 Directors PL Ste 150
San Diego, CA 92121-3801

Mailing address

4910 Directors PL Ste 150
San Diego, CA 92121-3801
Phone (855) 360-6730

Other identifiers 10

IdentifierTypeStateIssuer
G89081OtherCASTATE LICENSE
P2526820OtherNYOXFORD ID #
0297816OtherNYGHI PPO ID #
7672216OtherNYAETNA PPO ID #
000000073002OtherNYGHI HMO ID #
2631049OtherNYAETNA HMO ID #
192851OtherNYHIP ID #
N97319OtherNYHEALTHNET #
01586814MedicaidNY
475C41OtherNYEMPIRE BC/BS OF NY ID #

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
192851NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Elj Obstetrics & Gynecology Group, PLLC Specialist Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lchang80874@scrippshlth.medalliesdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1275593261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 DIRECTORS PL STE 150",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213801",
            "telephone_number": "855-360-6730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 DIRECTORS PL STE 150",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213801",
            "telephone_number": "855-360-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "LYNDON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "192851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "G89081",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD ID #",
            "identifier": "P2526820",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PPO ID #",
            "identifier": "0297816",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO ID #",
            "identifier": "7672216",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI HMO ID #",
            "identifier": "000000073002",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO ID #",
            "identifier": "2631049",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP ID #",
            "identifier": "192851",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET #",
            "identifier": "N97319",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01586814",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC/BS OF NY ID #",
            "identifier": "475C41",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; 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.