NPIMap

Individual provider Active NPI

Michael Yushun Chang, D.O.

  • Family Medicine Physician
  • The Woodlands, TX
National Provider Identifier
1346237872
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K8613 Issued in TX
Practice address
3115 College Park Dr Ste 107
The Woodlands, TX 77384-4001
Phone
(936) 321-6787
Fax
(936) 321-6802
NPI assigned
Sep 30, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K8613 TX Primary

Addresses

Primary practice location

3115 College Park Dr Ste 107
The Woodlands, TX 77384-4001

Mailing address

3115 College Park Dr Ste 107
The Woodlands, TX 77384-4001
Phone (936) 321-6787

Other identifiers 1

IdentifierTypeStateIssuer
165452702MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050202000447 TX Practitioner - Family Practice 2668423104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Texas HSC, College of Osteopathic Med, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3115 College Park Dr
The Woodlands, TX 77384-4001
Phone (936) 321-6787

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Suncoast Medical Group Inc Past Accepting new patients
Winnie-Stowell Hospital District Past Accepting new patients
Baylor College of Medicine Past Accepting new patients
Southwest Doctors PA Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4066/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/DCEJAA/Endpoint/DCEJAA

Organizations & group practices 5

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 8

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1346237872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 COLLEGE PARK DR STE 107",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773844001",
            "telephone_number": "936-321-6787",
            "fax_number": "936-321-6802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 COLLEGE PARK DR STE 107",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773844001",
            "telephone_number": "936-321-6787",
            "fax_number": "936-321-6802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "MICHAEL",
        "middle_name": "YUSHUN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K8613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165452702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

Verify at the official NPI Registry.