Individual provider Active NPI

Philip CHI-Luen Chang, M.D.

  • Pediatrics Physician
  • Boynton Beach, FL
National Provider Identifier
1497954879
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME99379 Issued in FL
Practice address
10301 Hagen Ranch Rd
BLDG. a, Ste 760
Boynton Beach, FL 33437-3724
Phone
(561) 733-4400
Fax
(561) 733-5004
NPI assigned
Jul 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME99379 FL Primary

Addresses

Primary practice location

10301 Hagen Ranch Rd
BLDG. a, Ste 760
Boynton Beach, FL 33437-3724

Mailing address

900 S Pine Island Rd
Suite 800
Plantation, FL 33324-3920
Phone (561) 733-4400

Other identifiers 1

IdentifierTypeStateIssuer
278747400MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240516001738 FL Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 8325489727

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME99379FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saltzman, Tanis, Pittell, Levin and Jacobson Pediatrics Past Accepting new patients
Saltzman, Tanis, Pittel, Levin and Jacobson Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: pchang@pa.trimed.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1497954879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S PINE ISLAND RD",
            "address_2": "SUITE 800",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243920",
            "telephone_number": "561-733-4400",
            "fax_number": "561-733-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10301 HAGEN RANCH RD",
            "address_2": "BLDG. A, STE 760",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334373724",
            "telephone_number": "561-733-4400",
            "fax_number": "561-733-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "PHILIP",
        "middle_name": "CHI-LUEN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-16",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME99379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278747400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.