Individual provider Active NPI

Jonathan I Chang, M.D.

  • Gastroenterology Physician
  • Los Angeles, CA
National Provider Identifier
1285053298
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A137665 Issued in CA
Practice address
1526 N Edgemont St FL 7
Los Angeles, CA 90027-5260
Phone
(323) 819-2651
Fax
(866) 455-3867
NPI assigned
Apr 8, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A137665 CA
Gastroenterology Physician 207RG0100X A137665 CA Primary

Addresses

Primary practice location

1526 N Edgemont St FL 7
Los Angeles, CA 90027-5260

Mailing address

1526 N Edgemont St FL 7
Los Angeles, CA 90027-5260

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160520000615 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 2466752779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of Southern California Keck School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1526 N Edgemont St
Los Angeles, CA 90027-5260
Phone (323) 783-4011

4725 -4733 Sunset Blvd
Los Angeles, CA 90027-6021
Phone (323) 783-4011

4733 W Sunset Blvd
Los Angeles, CA 90027-6021
Phone (213) 667-4784

4867 W Sunset Blvd
Los Angeles, CA 90027-5969
Phone (323) 783-4011

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
137665CAMDClinical Social Worker
A137665CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

4733 W Sunset Blvd
Fl 3
Los Angeles, CA 90027
Phone (323) 783-1431

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

Organizations & group practices 1

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 1

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": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1285053298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 N EDGEMONT ST FL 7",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 N EDGEMONT ST FL 7",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275260",
            "telephone_number": "323-819-2651",
            "fax_number": "866-455-3867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "JONATHAN",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-08",
        "last_updated": "2021-12-08",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A137665",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A137665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4733 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.