NPIMap

Individual provider Active NPI

Alvin Chang, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Tustin, CA
National Provider Identifier
1396857181
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
A55330 Issued in CA
Practice address
1101 Bryan Ave
Suite E
Tustin, CA 92780-4401
Phone
(714) 352-5800
Fax
(714) 352-5801
NPI assigned
Aug 31, 2006
Last updated
Sep 19, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X A55330 CA Primary

Addresses

Primary practice location

1101 Bryan Ave
Suite E
Tustin, CA 92780-4401

Mailing address

1101 Bryan Ave
Suite E
Tustin, CA 92780-4401
Phone (714) 352-5800

Other identifiers 4

IdentifierTypeStateIssuer
W18492OtherMEDICARE GRP NUMBER
00A553300MedicaidCA
DT9847OtherCAOCSC GROUP PTAN
1699040170OtherCAOCSC GROUP NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041213000274 CA Practitioner - Internal MedicinePractitioner - Geriatric Medicine 2365409232 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
University of California, Geffen School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Access Community Health CenterGroup PAC ID 7810394756, 29 clinicians

Practice addresses (Care Compare)

520 N Main St
Suite 120
Santa Ana, CA 92701-4623
Phone (714) 352-5800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55330CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
New Foundation Medical Inc. Geriatric Medicine CurrentSince Sep 20, 2016 Accepting new patients
Chapman Medical Center Inc Past Accepting new patients
John F. Randolph,M.D.,Inc. Geriatric Medicine Past Accepting new patients
GN Medical Associates, Inc. PastSince Apr 1, 2007 Accepting new patients
South Coast Global Medical Center, Inc Past Accepting new patients
Renew Healthcare Systems, Inc. Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients

Locations

24953 Paseo de Valencia
Ste 7C
Laguna Hills, CA 92653
Phone (714) 352-5800

6960 Magnolia Ave
Ste 203
Riverside, CA 92506
Phone (714) 352-5800

520 N Main St
Ste 120
Santa Ana, CA 92701
Phone (714) 352-5800

520 N Main St
Ste 220
Santa Ana, CA 92701
Phone (714) 352-5800

1101 Bryan Ave
Ste E
Tustin, CA 92780
Phone (714) 352-5800

14642 Newport Ave
Ste 101
Tustin, CA 92780
Phone (714) 352-5800

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Regents Point - WindcrestIrvine, CA, CCN 555295 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Nov 1, 2008
Nov 1, 2008
Plaza Healthcare CenterSanta Ana, CA, CCN 055206 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2025
Jan 1, 2025

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 9

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 12

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1396857181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 BRYAN AVE",
            "address_2": "SUITE E",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927804401",
            "telephone_number": "714-352-5800",
            "fax_number": "714-352-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 BRYAN AVE",
            "address_2": "SUITE E",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927804401",
            "telephone_number": "714-352-5800",
            "fax_number": "714-352-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "ALVIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A55330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GRP NUMBER",
            "identifier": "W18492",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A553300",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCSC GROUP PTAN",
            "identifier": "DT9847",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCSC GROUP NPI",
            "identifier": "1699040170",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.