Individual provider Active NPI

Sukyoon Chang, PA-C, LAT, ATC

  • Surgical Physician Assistant
  • Spartanburg, SC
National Provider Identifier
1295335487
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
5744 Issued in SC
Practice address
1330 Boiling Springs Rd Ste 1600
Spartanburg, SC 29303-4219
Phone
(864) 582-6396
NPI assigned
Oct 28, 2020
Sex
Male
Sole proprietor
No

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Orthopaedic and Neurosurgical Associates 65 clinicians

Practice addresses (Care Compare)

115 Deacon Tiller CT
Duncan, SC 29334-8880
Phone (864) 582-6396

1330 Boiling Springs Rd
Suite 1600
Spartanburg, SC 29303-4219
Phone (864) 582-6396

220 Roper Mountain Rd Ext
Greenville, SC 29615-4886
Phone (864) 582-6396

Hospital & facility affiliations

  • Spartanburg Medical Center Hospital, Spartanburg, SC, CCN 420007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20250310003602 SC Practitioner - Physician Assistant 5294256939 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5744SCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Orthopaedic and Neurosurgical Associates CurrentSince Feb 10, 2025 Accepting new patients
Carolina Orthopaedic and Neurosurgical Associates Surgical CurrentSince Feb 10, 2025 Accepting new patients

Locations

115 Deacon Tiller Ct
Duncan, SC 29334
Phone (864) 582-6396

220 Roper Mountain Road Ext
Greenville, SC 29615
Phone (864) 242-1163

1330 Boiling Springs Rd
Ste 1600
Spartanburg, SC 29303
Phone (864) 582-6396

1330 Boiling Springs Rd
Ste 1600B
Spartanburg, SC 29303
Phone (864) 582-0019

Interoperability endpoints

  • Direct secure messaging: sukyoon.chang.1@26879.direct.athenahealth.com

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Surgical Physician Assistant 363AS0400X 5744 SC Primary

Addresses

NPPES NPI Registry

Primary practice location

1330 Boiling Springs Rd Ste 1600
Spartanburg, SC 29303-4219

Mailing address

1725 Tudor Dr
Ann Arbor, MI 48103-4445

Other practice location 1

8111 S Emerson Ave
Indianapolis, IN 46237-8601
Phone (317) 528-5000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 19, 2025.

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1295335487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 TUDOR DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481034445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 BOILING SPRINGS RD STE 1600",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293034219",
            "telephone_number": "864-582-6396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8111 S Emerson Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462378601",
            "country_code": "US",
            "telephone_number": "317-528-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "SUKYOON",
        "name_prefix": "Mr.",
        "credential": "PA-C, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-28",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": "5744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.