NPIMap

Individual provider Active NPI

Ellen Yulin Chang, MD

  • Diagnostic Radiology Physician
  • San Francisco, CA
National Provider Identifier
1427450212
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A168940 Issued in CA
Practice address
1001 Potrero Avenue
Building 5, 1St Floor
San Francisco, CA 94110-3518
Phone
(628) 206-8020
NPI assigned
Sep 23, 2014
Last updated
Aug 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2019019873 MO
Diagnostic Radiology Physician 2085R0202X A168940 CA Primary

Addresses

Primary practice location

1001 Potrero Avenue
Building 5, 1St Floor
San Francisco, CA 94110-3518

Mailing address

PO Box 743749
Los Angeles, CA 90074-3749

Other practice location 1

1500 San Pablo St Fl 2
Los Angeles, CA 90033-5313
Phone (323) 442-8541

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ellen.ychang@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190626000830 MO Practitioner - Diagnostic Radiology 7911205372 Reassigns benefits to 2 organizations
I20200619001405 CA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 7911205372 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City and County of San FranciscoGroup PAC ID 1658280748, 368 clinicians

Practice addresses (Care Compare)

1001 Potrero Ave
San Francisco, CA 94110-3518
Phone (415) 206-2305

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A168940CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California SFGH Medical Group CurrentSince Sep 1, 2022 Accepting new patients
University of California SFGH Medical Group Diagnostic Radiology CurrentSince Sep 1, 2022 Accepting new patients
Miracl, LLC CurrentSince Jun 15, 2019 Accepting new patients
City & County of San Francisco CurrentSince Aug 23, 2022 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jun 9, 2020 Accepting new patients
City and County of San Francisco CurrentSince Aug 23, 2022 Accepting new patients
Usc Care Medical Group, Inc Diagnostic Radiology CurrentSince Jun 9, 2020 Accepting new patients
Washington University Diagnostic Radiology CurrentSince Jun 15, 2019 Accepting new patients
City & County of San Francisco Current Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

1500 San Pablo St
Fl 2
Los Angeles, CA 90033
Phone (323) 442-8541

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5860

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

1001 Potrero Ave
Bldg 20
San Francisco, CA 94110
Phone (415) 206-8524

1001 Potrero Ave
Bldg 5
San Francisco, CA 94110
Phone (628) 206-5753

375 Laguna Honda Blvd
San Francisco, CA 94116
Phone (415) 759-2300

1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

510 S Kingshighway Blvd
Saint Louis, MO 63110
Phone (314) 362-0177

510 S Kingshighway Blvd
#8131
Saint Louis, MO 63110
Phone (314) 362-2978

660 S Euclid Ave
#8131
Saint Louis, MO 63110
Phone (314) 362-2809

Interoperability endpoints

  • Direct secure messaging: ellen.ychang@direct.usc.edu

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 6

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": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1427450212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743749",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900743749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVENUE",
            "address_2": "BUILDING 5, 1ST FLOOR",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "628-206-8020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 San Pablo St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900335313",
            "country_code": "US",
            "telephone_number": "323-442-8541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "ELLEN",
        "middle_name": "YULIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-23",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2019019873",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A168940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ellen.ychang@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1500 San Pablo St Fl 2",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.