Individual provider Active NPI

Maria Chang, M.D.

  • Pediatrics Physician
  • San Jose, CA
National Provider Identifier
1316294994
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A130242 Issued in CA
Practice address
751 S Bascom Ave
San Jose, CA 95128
Phone
(408) 885-5000
NPI assigned
Aug 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X A130242 CA
Pediatrics Physician 208000000X A130242 CA Primary

Addresses

Primary practice location

751 S Bascom Ave
San Jose, CA 95128

Mailing address

PO Box 226
Menlo Park, CA 94026-0226

Other practice location 1

1000 W Carson St
Department of Pediatrics
Torrance, CA 90502-2004
Phone (310) 222-2342

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
I20191126002796 CA Practitioner - Pediatric Medicine 6709219090 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A130242CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara Pediatrics Current Accepting new patients
County of Santa Clara CurrentSince Oct 1, 2019 Accepting new patients
County of Santa Clara CurrentSince Oct 1, 2019 Accepting new patients
County of Santa Clara CurrentSince Oct 1, 2019 Accepting new patients
County of Santa Clara CurrentSince Oct 1, 2019 Accepting new patients
County of Santa Clara Current Accepting new patients

Locations

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

1996 Lundy Ave
San Jose, CA 95131
Phone (408) 299-5846

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

2101 Alexian Dr
San Jose, CA 95116
Phone (408) 272-6050

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

Interoperability endpoints

  • Direct secure messaging: mchang139538@santaclaravalley.direct-ci.net

Organizations & group practices 6

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": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1316294994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 226",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940260226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95128",
            "telephone_number": "408-885-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 W Carson St",
            "address_2": "Department of Pediatrics",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905022004",
            "country_code": "US",
            "telephone_number": "310-222-2342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "MARIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-13",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "CA",
            "license": "A130242",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A130242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.