Thomas Y Chang, MDS

Primary specialty

DentistTaxonomy code 122300000X

License

17581 Issued in MA

Practice address

63 Main St
Brockton, MA 02301-4042

Phone

(508) 559-6699

Fax

(508) 930-5073

NPI assigned

Oct 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et1290.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• Brockton Neighborhood Health Center

  • Federally Qualified Health Center (FQHC)
  • Brockton, MA
  • NPI 1225085319
  Medicare reassignment NPD
• Brockton Neighborhood Health Center

  • Federally Qualified Health Center (FQHC)
  • Brockton, MA
  • NPI 1548663875
  NPD
• Brockton Neighborhood Health Center, Inc.

  • Community/Retail Pharmacy
  • Brockton, MA
  • NPI 1528704061
  NPD

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278892800000",
    "number": "1548350549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014042",
            "telephone_number": "508-559-6699",
            "fax_number": "508-559-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014042",
            "telephone_number": "508-559-6699",
            "fax_number": "508-930-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "THOMAS",
        "middle_name": "Y",
        "credential": "MDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2010-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "17581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "V05568",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ponniece Champlin
• Tanaisha A. Chance
• Karlyne Chanel
• Grace Chang, MD
• Howard H Chang, M.D.
• Wendy Chapdelaine
• Nancy Lynn Chapin, M.D.
• Michelle Marie Chapman
• Tori-Anne Charette-Bjorkman
• Richard Charity, PA-C

• Dentist in Brockton, MA
• Providers in Brockton, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.