Active NPI
Noelle Brianna Tchang, OD
- Optometrist
- Fountain Hills, AZ
National Provider Identifier
1285204875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT-002494
- Practice address
- 15724 E Kim Dr
Fountain Hills, AZ 85268-1800 - Phone
- (907) 394-8852
- NPI assigned
- Jun 28, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT-002494 | AZ | Primary |
Addresses
Primary practice location
15724 E Kim Dr
Fountain Hills, AZ 85268-1800
Mailing address
15724 E Kim Dr
Fountain Hills, AZ 85268-1800
Phone (907) 394-8852
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Southern College of Optometry, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
20 Peachtree CT
Suite 103H
Holbrook, NY 11741-4616
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary Imogene Bassett Hospital | Current | Accepting new patients | |
| Mary Imogene Bassett Hospital | Current | Accepting new patients | |
| 20/20 Vision Services PC | Optometrist | Current | Accepting new patients |
Locations
20 Peachtree Ct
Ste 103H
Holbrook, NY 11741
Phone (201) 572-4039
1887 Elmira St
Sayre, PA 18840
Phone (570) 888-3729
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.
-
- Specialty Pharmacy
- Oneonta, NY
- NPI 1174419196
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624838400000",
"number": "1285204875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15724 E KIM DR",
"city": "FOUNTAIN HILLS",
"state": "AZ",
"postal_code": "852681800",
"telephone_number": "907-394-8852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15724 E KIM DR",
"city": "FOUNTAIN HILLS",
"state": "AZ",
"postal_code": "852681800",
"telephone_number": "907-394-8852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TCHANG",
"first_name": "NOELLE",
"middle_name": "BRIANNA",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-28",
"last_updated": "2021-06-28",
"certification_date": "2021-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AZ",
"license": "OPT-002494",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fountain Hills, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.