NPIMap

Individual provider Active NPI

Peter Chang, MD

  • Diagnostic Radiology Physician
  • Austin, TX
National Provider Identifier
1518928126
Registry record updated Dec 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
F5492 Issued in TX
Practice address
6402 Dry Cliff CV
Austin, TX 78731-3918
Phone
(512) 459-5158
Fax
(512) 450-1056
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X F5492 TX Primary

Addresses

Primary practice location

6402 Dry Cliff CV
Austin, TX 78731-3918

Mailing address

6402 Dry Cliff CV
Austin, TX 78731-3918
Phone (512) 459-5158

Other identifiers 4

IdentifierTypeStateIssuer
132497210MedicaidTX
DG697MedicaidTX
132497211MedicaidTX
128025706MedicaidTX

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Seton Past Accepting new patients
Smithville Hospital Authority Past Accepting new patients
Blackhawk Physician Group Past Accepting new patients
Innovative Radiology PA Diagnostic Radiology PastSince May 1, 2015 Accepting new patients

Organizations & group practices 4

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450656000000",
    "number": "1518928126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6402 DRY CLIFF CV",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787313918",
            "telephone_number": "512-459-5158",
            "fax_number": "512-450-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6402 DRY CLIFF CV",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787313918",
            "telephone_number": "512-459-5158",
            "fax_number": "512-450-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2015-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "F5492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132497210",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DG697",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132497211",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128025706",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.