Michael Keewook Chang, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

MD477395 Issued in PA

Practice address

255 W Lancaster Ave
Paoli, PA 19301-1763

Phone

(484) 565-1510

Fax

(484) 565-1513

NPI assigned

Jun 7, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

HospitalistAlso: Internal Medicine

Education

Loma Linda University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Paoli Hospital Hospital, Paoli, PA, CCN 390153
• Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
• Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643

  Internal Medicine

  Medicare reassignment Care Compare group NPD

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

• Main Line Hospitals, Inc.

  • General Acute Care Hospital
  • Paoli, PA
  • NPI 1215042114
  Care Compare affiliation
• Main Line Hospitals, Inc.

  • General Acute Care Hospital
  • Wynnewood, PA
  • NPI 1245335629
  Care Compare affiliation
• Main Line Hospitals, Inc.

  • General Acute Care Hospital
  • Bryn Mawr, PA
  • NPI 1508971441
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1356900930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W LANCASTER AVE",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011763",
            "telephone_number": "484-565-1510",
            "fax_number": "484-565-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W LANCASTER AVE",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011763",
            "telephone_number": "484-565-1510",
            "fax_number": "484-565-1513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11234 Anderson St",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542804",
            "country_code": "US",
            "telephone_number": "909-558-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "MICHAEL",
        "middle_name": "KEEWOOK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-07",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD477395",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD477395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francine A. Cedrone, M.D.
• Albert J Celidonio, RPH
• Alyssa Centrella, DPT
• CFL Associates LTD.
• Jasyn Yanbo Chang, DO
• Shu Mei Jessie Chang, DDS
• Michelle Lee Chappelle, CRNP
• Charli Morris LLC
• Candice Ashley Charlton-Bjorheim, LBS
• Julius R Chiappa, D.D.S.

• Hospitalist Physician in Paoli, PA
• Providers in Paoli, PA by specialty
• Hospitalist Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; 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.

Verify at the official NPI Registry.