Active NPI
Bao Chang, M.D.
- Psychiatry Physician
- Menlo Park, CA
National Provider Identifier
1508068156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- G069845
- Practice address
- 1225 Crane St
Suite 203
Menlo Park, CA 94025-4257 - Phone
- (650) 321-8881
- Fax
- (650) 324-8700
- NPI assigned
- Jun 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | G069845 | CA | Primary |
Addresses
Primary practice location
1225 Crane St
Suite 203
Menlo Park, CA 94025-4257
Mailing address
1225 Crane St
Suite 203
Menlo Park, CA 94025-4257
Phone (650) 321-8881
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G069845 | Other | CA | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 16, 2013 through Dec 16, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69845 | CA | MD | Pharmacist |
| G069845 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychiatric Centers at San Diego, Inc. Med GRP | Past | Accepting new patients |
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 1
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.
-
- Mental Health Counselor
- San Diego, CA
- NPI 1841241585
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1508068156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1225 CRANE ST",
"address_2": "SUITE 203",
"city": "MENLO PARK",
"state": "CA",
"postal_code": "940254257",
"telephone_number": "650-321-8881",
"fax_number": "650-324-8700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 CRANE ST",
"address_2": "SUITE 203",
"city": "MENLO PARK",
"state": "CA",
"postal_code": "940254257",
"telephone_number": "650-321-8881",
"fax_number": "650-324-8700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "BAO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-05",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G069845",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "G069845",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Menlo Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.