NPIMap

Individual provider Active NPI

Jerry W Chang, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Garden City, NY
National Provider Identifier
1518136027
Registry record updated May 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
257199 Issued in NY
Practice address
999 Franklin Ave
Garden City, NY 11530-2913
Phone
(516) 742-3404
Fax
(516) 742-4716
NPI assigned
Feb 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 239779 MA
Plastic and Reconstructive Surgery Physician 2086S0122X 257199 NY Primary

Addresses

Primary practice location

999 Franklin Ave
Garden City, NY 11530-2913

Mailing address

999 Franklin Ave
Garden City, NY 11530-2913
Phone (516) 742-3404

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101019001296 NY Practitioner - Plastic and Reconstructive Surgery 9931245123 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Washington University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Long Island Plastic Surgical Group, PCGroup PAC ID 1153340054, 39 clinicians

Practice addresses (Care Compare)

999 Franklin Ave
Garden City, NY 11530-2913

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy19
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Plastic Surgical Group, PC CurrentSince Sep 1, 2010 Accepting new patients
Nassau Health Care Corporation CurrentSince Jan 30, 2011 Accepting new patients
Numc Department of Gast/Derm, FPP CurrentSince Jan 30, 2011 Accepting new patients
Nassau Health Care Corporation Current Accepting new patients
South Nassau Communities Hospital Past Accepting new patients

Locations

2201 Hempstead Tpke
Rm 2448
East Meadow, NY 11554
Phone (516) 572-1234

2201 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 486-6862

13620 38th Ave
Ste 5E
Flushing, NY 11354
Phone (718) 358-5868

999 Franklin Ave
Ste 300
Garden City, NY 11530
Phone (516) 535-6778

999 Franklin Ave
Garden City, NY 11530
Phone (516) 742-3404

2200 Northern Blvd
Ste 201
Greenvale, NY 11548

206 E Jericho Tpke
Huntington Station, NY 11746
Phone (631) 847-0200

27005 76th Ave
North New Hyde Pk, NY 11040

Networks

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

Interoperability endpoints

  • Direct secure messaging: jchang307931@nyumc.direct-ci.com
  • Direct secure messaging: jwc9003@direct.nyp.org

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401235200000",
    "number": "1518136027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 FRANKLIN AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302913",
            "telephone_number": "516-742-3404",
            "fax_number": "516-742-4716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 FRANKLIN AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302913",
            "telephone_number": "516-742-3404",
            "fax_number": "516-742-4716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "JERRY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-28",
        "last_updated": "2014-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MA",
            "license": "239779",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NY",
            "license": "257199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

Verify at the official NPI Registry.