Individual provider Active NPI

Patrick See-Yim Chang, P.T.

  • Physical Therapist
  • New York, NY
National Provider Identifier
1417082330
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
012335-1 Issued in NY
Practice address
17 Elizabeth St Ste 303
New York, NY 10013-4803
Phone
(212) 625-2528
Fax
(212) 625-0886
NPI assigned
Feb 22, 2007
Last updated
Feb 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 012335-1 NY Primary

Addresses

Primary practice location

17 Elizabeth St Ste 303
New York, NY 10013-4803

Mailing address

17 Elizabeth St Ste 303
New York, NY 10013-4803
Phone (212) 625-2528

Other identifiers 1

IdentifierTypeStateIssuer
01584770MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091217000052 NY Practitioner - Physical Therapist in Private Practice 1456491729 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physio-Rehab, P.C.Group PAC ID 8527108760, 2 clinicians

Practice addresses (Care Compare)

17 Elizabeth St
Suite 303
New York, NY 10013-4803
Phone (212) 625-2528

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012335-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physio-Rehab, P.C. Physical Therapist CurrentSince Feb 3, 1993 Accepting new patients
Physical Rehab PT, PLLC Physical Therapist CurrentSince Feb 16, 2020 Accepting new patients

Locations

13 Elizabeth St
Ste 303
New York, NY 10013

17 Elizabeth St
Ste 303
New York, NY 10013
Phone (212) 625-2528

408 W 57th St
Apt 1L
New York, NY 10019
Phone (212) 397-5140

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1417082330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 ELIZABETH ST STE 303",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134803",
            "telephone_number": "212-625-2528",
            "fax_number": "212-625-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 ELIZABETH ST STE 303",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134803",
            "telephone_number": "212-625-2528",
            "fax_number": "212-625-0886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "PATRICK",
        "middle_name": "SEE-YIM",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "012335-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01584770",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.