Individual provider Active NPI

Christine Jingwen Chang, APRN, NP-C, FNP-BC

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1477069284
Registry record updated Apr 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F10170968 Issued in NY
Practice address
545 1St Ave
New York, NY 10016-6401
Phone
(212) 263-6696
Fax
(646) 754-7057
NPI assigned
Dec 17, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F10170968 NY Primary

Addresses

Primary practice location

545 1St Ave
New York, NY 10016-6401

Mailing address

696 Frick St
Elmont, NY 11003-4135
Phone (917) 355-6554

Other identifiers 2

IdentifierTypeStateIssuer
F342446-1OtherNYFNP LICENSE
14202227OtherNYCAQH

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250922000736 NY Order and Referring Only - Nurse Practitioner 7214290840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F10170968NYMDFamily Nurse Practitioner

Networks

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

Interoperability endpoints

  • Direct secure messaging: cchang1328768@nychhc.direct-ci.com
  • Direct secure messaging: cchang301340@nyumc.direct-ci.com
  • Direct secure messaging: christine.chang.1@24989.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1513468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745712000000",
    "number": "1477069284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "696 FRICK ST",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110034135",
            "telephone_number": "917-355-6554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166401",
            "telephone_number": "212-263-6696",
            "fax_number": "646-754-7057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "CHRISTINE",
        "middle_name": "JINGWEN",
        "name_prefix": "Ms.",
        "credential": "APRN, NP-C, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-17",
        "last_updated": "2025-04-27",
        "certification_date": "2025-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F10170968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FNP LICENSE",
            "identifier": "F342446-1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14202227",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.