Individual provider Active NPI

Jeanne Christine Chang, O.D.

  • Optometrist
  • Fremont, CA
National Provider Identifier
1609006261
Registry record updated Jul 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13742 Issued in CA
Practice address
41481 Beatrice St
Fremont, CA 94539-4534
Phone
(510) 498-4489
NPI assigned
Jul 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13742 CA Primary

Addresses

Primary practice location

41481 Beatrice St
Fremont, CA 94539-4534

Mailing address

41481 Beatrice St
Fremont, CA 94539-4534
Phone (510) 498-4489

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20140224000680 CA Order and Referring Only - OptometryPractitioner - Optometry 7810127651

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13742CAMDOptometrist

Interoperability endpoints

  • Direct secure messaging: jchang598252@direct.ochin.org

NPI Registry JSON

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247702400000",
    "number": "1609006261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41481 BEATRICE ST",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945394534",
            "telephone_number": "510-498-4489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41481 BEATRICE ST",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945394534",
            "telephone_number": "510-498-4489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "JEANNE CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-16",
        "last_updated": "2009-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.