Simone M Chang, MD

Primary specialty

Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X

License

ME166105 Issued in FL

Practice address

2 Tampa General Cir
Tampa, FL 33606-3571

Phone

(813) 821-8038

Fax

(813) 974-0483

NPI assigned

May 4, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in TX, FL2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
• Direct secure messaging: schang282292@direct.tgh.org

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.

• University Medical Service Association Inc

  • Physical Therapist
  • Tampa, FL
  • NPI 1992742324
  Medicare reassignment NPD
• Texas Tech University Health Sciences Center El Paso

  • Internal Medicine Physician
  • El Paso, TX
  • NPI 1598705055
  Medicare reassignment NPD
• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD
• University Medical Service Association Inc

  • Durable Medical Equipment & Medical Supplies
  • Tampa, FL
  • NPI 1194276576
  NPD
• University Medical Service Association Inc

  • General Practice Physician
  • Tampa, FL
  • NPI 1326088295
  NPD
• Texas Tech University Health Sciences Center El Paso

  • Pediatrics Physician
  • El Paso, TX
  • NPI 1003824038
  NPD
• Texas Tech University Health Sciences Center El Paso

  • Neurological Surgery Physician
  • El Paso, TX
  • NPI 1457913444
  NPD
• University Medical Service Association Inc

  • Neurological Surgery Physician
  • Tampa, FL
  • NPI 1740227966
  NPD (past)
• Texas Tech University Health Sciences Center Odessa

  • Family Medicine Physician
  • Odessa, TX
  • NPI 1407845084

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1588010953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001",
            "telephone_number": "813-821-8038",
            "fax_number": "813-974-0483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 TAMPA GENERAL CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063571",
            "telephone_number": "813-821-8038",
            "fax_number": "813-974-0483"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4845 Alameda Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799052705",
            "country_code": "US",
            "telephone_number": "915-215-5700",
            "fax_number": "915-215-8872",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4815 Alameda Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799052705",
            "country_code": "US",
            "telephone_number": "915-215-5700",
            "fax_number": "915-215-8872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "SIMONE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-04",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "T4722",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "TX",
            "license": "T4722",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "FL",
            "license": "ME166105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121243000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "XLB2I",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "simone.chang@louisville.edu",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "LOUISVILLE",
            "address_1": "571 S Floyd St Ste 445",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402023877",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "schang282292@direct.tgh.org",
            "affiliation": "N",
            "address_1": "2 Tampa General Cir",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sherissa Chang-Williams, PA-C
• Chih-Chien Charlton Chang, M.D.
• John Chang, M.D.,FACP,FACG
• Juliana Y. Chang, DMD
• Peter Travis Riad Chang, M.D.
• Young Doo Chang, M.D.
• Change the Narrative Counseling LLC
• Varun Channagiri, M.D.
• Kimberly Anne Channels, PA
• Channelside Optical LLC (Opes Optical)

• Pediatric Hematology & Oncology Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Pediatric Hematology & Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.