Individual provider Active NPI

Jewell Renee Chang, OD

  • Optometrist
  • Jensen Beach, FL
National Provider Identifier
1407830730
Registry record updated May 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC2950 Issued in FL
Practice address
3201 NE Skyline Dr Ste D
Jensen Beach, FL 34957-3912
Phone
(772) 334-4264
Fax
(772) 334-4265
NPI assigned
Nov 30, 2005
Last updated
May 11, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC2950 FL Primary

Addresses

Primary practice location

3201 NE Skyline Dr Ste D
Jensen Beach, FL 34957-3912

Mailing address

3201 NE Skyline Dr
Ste D
Jensen Beach, FL 34957-3912
Phone (772) 334-4264

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060502000332 FL Practitioner - Optometry 4789694001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3201 NE Skyline Dr
Suite D
Jensen Beach, FL 34957-3912
Phone (772) 334-4264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jewell R. Chang OD PA Optometrist CurrentSince Jan 14, 2002 Accepting new patients
Delrowe Eye Care, PA Past Accepting new patients
Osceola Optique PastSince Jan 14, 2002 Accepting new patients

Locations

3201 NE Skyline Dr
Ste D
Jensen Beach, FL 34957
Phone (772) 334-4264

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525996800000",
    "number": "1407830730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 NE SKYLINE DR",
            "address_2": "STE D",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349573912",
            "telephone_number": "772-334-4264",
            "fax_number": "772-334-4265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 NE SKYLINE DR STE D",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349573912",
            "telephone_number": "772-334-4264",
            "fax_number": "772-334-4265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "JEWELL",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2018-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jensen Beach, FL

Sources for this page

Verify at the official NPI Registry.