Individual provider Active NPI

Stephen Ting Chang, MD

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1386103646
Registry record updated May 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
291514 Issued in MA
Practice address
55 Fruit St
Blake 1500
Boston, MA 02114
Phone
(617) 724-3874
NPI assigned
Mar 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 291514 MA Primary
Internal Medicine Physician 207R00000X 279355 MA

Addresses

Primary practice location

55 Fruit St
Blake 1500
Boston, MA 02114

Mailing address

55 Fruit St
Blake 1500
Boston, MA 02114
Phone (617) 724-3874

Other practice location 1

725 Albany St
Boston, MA 02118-2526
Phone (617) 414-5951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20220729001695 MA Practitioner - Internal Medicine 0648504456 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Boston University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
291514MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General Hospital Corp Current Accepting new patients
The General Hospital Corporation CurrentSince Jul 1, 2022 Accepting new patients
Massachusetts General Physicians Organization Inc Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
#1500
Boston, MA 02114
Phone (617) 724-3842

Interoperability endpoints

  • Direct secure messaging: chang.stephen.mgh@direct.partners.masshiway.net

Organizations & group practices 3

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 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": "1552780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651795200000",
    "number": "1386103646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "BLAKE 1500",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-724-3874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "BLAKE 1500",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-724-3874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 Albany St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182526",
            "country_code": "US",
            "telephone_number": "617-414-5951",
            "fax_number": "617-414-9251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "STEPHEN",
        "middle_name": "TING",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-17",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "291514",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "279355",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.