Individual provider Active NPI

Daniel T Chang, M.D.

  • Diagnostic Radiology Physician
  • East Meadow, NY
National Provider Identifier
1366619017
Registry record updated May 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
235383 Issued in MA
Practice address
2201 Hempstead Tpke
East Meadow, NY 11554-1859
Phone
(516) 572-6633
NPI assigned
May 13, 2008
Last updated
May 13, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 235383 MA Primary

Addresses

Primary practice location

2201 Hempstead Tpke
East Meadow, NY 11554-1859

Mailing address

208 W 23Rd St
Apt. 506
New York, NY 10011-2306
Phone (516) 572-6633

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
I20091123000181 CA Practitioner - Diagnostic RadiologyPractitioner - Other (Physician) 0042373029 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
235383MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centrelake Medical Group, Inc. CurrentSince Jan 1, 2023 Accepting new patients
United Medical Doctors CurrentSince Oct 1, 2019 Accepting new patients
Centrelake Medical Group Inc Diagnostic Radiology CurrentSince Jan 1, 2023 Accepting new patients
County of Los Angeles CurrentSince Jul 28, 2015 Accepting new patients
Centrelake Medical Group, Inc. Diagnostic Radiology CurrentSince Dec 1, 2022 Accepting new patients
Centrelake Medical Group, Inc. Diagnostic Radiology CurrentSince Jan 1, 2023 Accepting new patients
Centrelake Medical Group, Inc. Diagnostic Radiology CurrentSince Jan 1, 2023 Accepting new patients
Centrelake Medical Group Inc Diagnostic Radiology CurrentSince Dec 1, 2022 Accepting new patients
Centrelake Medical Group Inc CurrentSince Nov 1, 2022 Accepting new patients
United Medical Doctors CurrentSince Oct 1, 2019 Accepting new patients
Centrelake Medical Group Inc CurrentSince Dec 1, 2022 Accepting new patients
County of Los Angeles CurrentSince Jul 28, 2015 Accepting new patients
Centrelake Medical Group Inc CurrentSince Jan 1, 2023 Accepting new patients
Centrelake Medical Group Inc Diagnostic Radiology CurrentSince Jan 1, 2023 Accepting new patients
Centrelake Medical Group Inc Diagnostic Radiology CurrentSince Jan 1, 2023 Accepting new patients
Focus Medical Imaging Diagnostic Radiology Past Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

2083 Compton Ave
Ste 104
Corona, CA 92881
Phone (951) 256-8191

521 E Elder St
Ste 104
Fallbrook, CA 92028
Phone (760) 728-9560

400 Newport Center Dr
Ste 609
Newport Beach, CA 92660
Phone (949) 760-0398

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

1000 W Carson St
Torrance, CA 90502
Phone (310) 222-3501

1000 W Carson St
#480
Torrance, CA 90502
Phone (310) 222-5026

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9170/brand/1/csg/1/fhir/r4

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1366619017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 W 23RD ST",
            "address_2": "APT. 506",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100112306",
            "telephone_number": "516-572-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 HEMPSTEAD TPKE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541859",
            "telephone_number": "516-572-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "DANIEL",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-13",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "235383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

Verify at the official NPI Registry.