Active NPI
Effie C Chang, MD
- Gynecology Physician
- New Haven, CT
National Provider Identifier
1487668943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 17026
- Practice address
- 136 Sherman Ave
Ste 302
New Haven, CT 06511 - Phone
- (203) 776-5360
- Fax
- (203) 787-4990
- NPI assigned
- Jul 28, 2006
- Last updated
- Jan 29, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | 17026 | CT | Primary |
Addresses
Primary practice location
136 Sherman Ave
Ste 302
New Haven, CT 06511
Mailing address
136 Sherman Ave
Ste 302
New Haven, CT 06511
Phone (203) 776-5360
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0468300001 | Other | CT | DMERC |
| 0468300001 | Other | CT | MEDICARE NSC |
| 010017026CT01 | Other | ANTHEM BC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17026 | CT | MD | Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pulmonary and Critical Care PC | Past | Accepting new patients |
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.
-
- Gynecology Physician
- New Haven, CT
- NPI 1154605293
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- Pulmonary Disease Physician
- Fairfield, CT
- NPI 1831440882
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264723200000",
"number": "1487668943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "136 SHERMAN AVE",
"address_2": "STE 302",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "06511",
"telephone_number": "203-776-5360",
"fax_number": "203-787-4990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "136 SHERMAN AVE",
"address_2": "STE 302",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "06511",
"telephone_number": "203-776-5360",
"fax_number": "203-787-4990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "EFFIE",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-28",
"last_updated": "2010-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "CT",
"license": "17026",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMERC",
"identifier": "0468300001",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE NSC",
"identifier": "0468300001",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC",
"identifier": "010017026CT01",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.