Individual provider Active NPI

Roscoe Chang

  • Foot & Ankle Surgery Podiatrist
  • Brooklyn, NY
National Provider Identifier
1477015980
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
007220 Issued in NY
Practice address
5615 7TH Ave FL 3
Brooklyn, NY 11220-3509
Phone
(718) 869-7256
NPI assigned
Apr 3, 2019
Last updated
Dec 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 007220 NY Primary

Addresses

Primary practice location

5615 7TH Ave FL 3
Brooklyn, NY 11220-3509

Mailing address

5615 7TH Ave FL 3
Brooklyn, NY 11220-3509
Phone (929) 266-6434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220707002679 NY Practitioner - Podiatry 0244610285 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Prime Podiatry P.C.Group PAC ID 6204207806, 2 clinicians

Practice addresses (Care Compare)

5615 7TH Ave
FL 3
Brooklyn, NY 11220-3509
Phone (929) 266-6434

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue28
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007220NYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Be Well Primary Health Care Center, LLC CurrentSince Aug 9, 2022 Accepting new patients
Foot Forward Podiatry PC CurrentSince Nov 15, 2022 Accepting new patients
Goldstep Ambulatory Surgery Center, LLC CurrentSince Aug 9, 2022 Accepting new patients
North Prime Podiatry P.C. CurrentSince Dec 1, 2022 Accepting new patients
Foot Forward Podiatry, LLC Foot & Ankle Surgery Past Accepting new patients
Chinatown Cardiology, P.C. PastSince Jul 1, 2022 Accepting new patients

Locations

3007 Farragut Rd
Brooklyn, NY 11210
Phone (347) 915-1177

1526 New Haven Ave
Far Rockaway, NY 11691
Phone (718) 471-7200

99 Wall St
#266
New York, NY 10005

918 James St
Syracuse, NY 13203
Phone (315) 474-1561

612 Corporate Way
Ste 2M
Vly Cottage, NY 10989
Phone (718) 362-1403

Networks

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

Organizations & group practices 6

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 5

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": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1477015980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5615 7TH AVE FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203509",
            "telephone_number": "929-266-6434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5615 7TH AVE FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203509",
            "telephone_number": "718-869-7256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "ROSCOE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-03",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "007220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.