Patrick Kung Sun Chang, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MA29139 Issued in NJ

Practice address

101 Old Short Hills Rd
Suite 206
West Orange, NJ 07052-1023

Phone

(973) 731-5005

Fax

(973) 325-6230

NPI assigned

Oct 18, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Saint Barnabas Outpatient Centers

  dba Diagnostic Imaging of Northfield

  • Radiology Clinic/Center
  • West Orange, NJ
  • NPI 1902144595
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324944000000",
    "number": "1578644217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 OLD SHORT HILLS RD",
            "address_2": "SUITE 206",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521023",
            "telephone_number": "973-731-5005",
            "fax_number": "973-325-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 OLD SHORT HILLS RD",
            "address_2": "SUITE 206",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521023",
            "telephone_number": "973-731-5005",
            "fax_number": "973-325-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "PATRICK",
        "middle_name": "KUNG SUN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2011-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "MA29139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1836005",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chaman Preet Singh Chahal, M.D.
• Elie Youssef Chakhtoura, M.D.
• Katherine Fair Chan, PH.D.
• Yi Hung Chan, DPM
• Kaliq Trimble Chang, MD
• Peiyun Chang, D.O.
• Charles M Cummins, OD, PA
• Sylvester Chastanet, LPC
• Tule Anita Chau, LCSW
• Chaudhari Family Eyecare Inc (West Orange Family Eyecare)

• Surgery Physician in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2011; 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.