Individual provider Active NPI

Brian Yishing Changlai, MD

  • Internal Medicine Physician
  • Manlius, NY
National Provider Identifier
1366425530
Registry record updated Nov 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
147291 Issued in NY
Practice address
4921 Briarwood LN
Manlius, NY 13104-1307
Phone
(315) 637-5986
Fax
(315) 632-4426
NPI assigned
Nov 22, 2005
Sex
Male
Sole proprietor
Yes

Organizations & group practices 8

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 6

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

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Manlius, NY 13104
Phone (315) 447-1505

Hospital & facility affiliations

  • University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241
  • Auburn Community Hospital Hospital, Auburn, NY, CCN 330235
  • St Joseph'S Hospital Health Center Hospital, Syracuse, NY, CCN 330140
  • Samaritan Medical Center Hospital, Watertown, NY, CCN 330157
  • Carthage Area Hospital, Inc Hospital, Carthage, NY, CCN 331318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040715000998 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4789663519 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brian Y Changlai MD PC Internal Medicine CurrentSince Sep 15, 1985 Accepting new patients
Loretto Health and Rehabilitation Center CurrentSince Jan 1, 2004 Accepting new patients
Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in Internal Medicine CurrentSince May 1, 2005 Accepting new patients
Department of Medicine Medical Service Group CurrentSince May 1, 2005 Accepting new patients
Clinton Square Operations LLC CurrentSince Mar 9, 2019 Accepting new patients
Onondaga Hill Internists, LLP Internal Medicine Past Accepting new patients
Loretto Rest Realty Corporation PastSince Nov 13, 2015 Accepting new patients
Cap Medical, LLC Past Accepting new patients

Locations

700 E Brighton Ave
Syracuse, NY 13205
Phone (315) 469-5570

4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-5011

4900 Broad Rd
Ste 2S
Syracuse, NY 13215
Phone (315) 492-5759

918 James St
Syracuse, NY 13203
Phone (315) 474-1561

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 147291 NY Primary
Cardiovascular Disease Physician 207RC0000X 147291 NY
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 147291 NY

Addresses

NPPES NPI Registry

Primary practice location

4921 Briarwood LN
Manlius, NY 13104-1307

Mailing address

4921 Briarwood LN
Manlius, NY 13104-1307
Phone (315) 637-5986

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
00922303MedicaidNY

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 26, 2012.

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353888000000",
    "number": "1366425530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4921 BRIARWOOD LN",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131041307",
            "telephone_number": "315-637-5986",
            "fax_number": "315-632-4426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 BRIARWOOD LN",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131041307",
            "telephone_number": "315-637-5986",
            "fax_number": "315-632-4426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANGLAI",
        "first_name": "BRIAN",
        "middle_name": "YISHING",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2012-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "147291",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "147291",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "147291",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00922303",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manlius, NY

Sources for this page

Verify at the official NPI Registry.