Individual provider Active NPI

Alexander Tae-Shik Chang, M.D.

  • Surgery Physician
  • Escondido, CA
National Provider Identifier
1376860056
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A123245 Issued in CA
Practice address
2130 Citracado Pkwy Ste 300
Escondido, CA 92029-4151
Phone
(760) 739-7666
NPI assigned
Apr 21, 2010
Last updated
Feb 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X A123245 CA Primary

Addresses

Primary practice location

2130 Citracado Pkwy Ste 300
Escondido, CA 92029-4151

Mailing address

120 Craven Rd Ste 201
San Marcos, CA 92078-4237
Phone (760) 291-6650

Other identifiers 1

IdentifierTypeStateIssuer
A123245OtherCAMEDICAL LICENSE

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
I20130717000660 CA Practitioner - Vascular Surgery 3870733744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Ohio State University College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arch Health Partners IncGroup PAC ID 9931239027, 141 clinicians

Practice addresses (Care Compare)

15611 Pomerado Rd
Poway, CA 92064-2437
Phone (858) 675-3100

2125 Citracado Pkwy
Escondido, CA 92029-4159

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
25.49 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
84.95

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion269
Varicose vein removal326
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arch Health Partners, Inc Surgery CurrentSince Jul 1, 2022 Accepting new patients
Palomar Health Past Accepting new patients

Locations

2130 Citracado Pkwy
Ste 300
Escondido, CA 92029
Phone (760) 291-6650

625 Citracado Pkwy
Ste 203
Escondido, CA 92025
Phone (760) 739-7666

555 E Valley Pkwy
Escondido, CA 92025
Phone (760) 739-3000

15611 Pomerado Rd
Ste 400
Poway, CA 92064
Phone (858) 613-8900

120 Craven Rd
Ste 201
San Marcos, CA 92078

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: alexander.chang.p1@direct.arch.nextgenshare.com

Organizations & group practices 2

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 1

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": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1376860056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 CRAVEN RD STE 201",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920784237",
            "telephone_number": "760-291-6650",
            "fax_number": "760-737-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 CITRACADO PKWY STE 300",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920294151",
            "telephone_number": "760-739-7666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "ALEXANDER",
        "middle_name": "TAE-SHIK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-21",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A123245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A123245",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.