Individual provider Active NPI

Andrew Chang, DO

  • Family Medicine Physician
  • Portland, OR
National Provider Identifier
1518451970
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO207327 Issued in OR
Practice address
415 N Killingsworth St Ste 103
Portland, OR 97217-2440
Phone
(971) 299-7548
NPI assigned
Jun 19, 2018
Last updated
Mar 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO207327 OR Primary

Addresses

Primary practice location

415 N Killingsworth St Ste 103
Portland, OR 97217-2440

Mailing address

PO Box 86700
Portland, OR 97286-0700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220831000364 OR Practitioner - Hospice/Palliative CarePractitioner - Family Practice 3274882592 Reassigns benefits to 3 organizations
I20241211000648 WA Practitioner - Family Practice 3274882592 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO207327ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Dec 2, 2024 Accepting new patients
Providence Health & Services Oregon CurrentSince Aug 12, 2022 Accepting new patients
Providence Health & Services - Oregon Family Medicine CurrentSince Aug 12, 2022 Accepting new patients
Providence Health & Services - Oregon Family Medicine CurrentSince Aug 12, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Dec 2, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Dec 2, 2024 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

9800 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2457

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

500 NE Multnomah St
Fl 11
Portland, OR 97232

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1518451970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86700",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972860700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N KILLINGSWORTH ST STE 103",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972172440",
            "telephone_number": "971-299-7548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-19",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO207327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.