Michael Chang
Individual provider Active NPI Nephrology Physician · Queens, NY
NPI 1619435898 · NPPES record last updated Jun 10, 2024
Key facts
- NPI
- 1619435898
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nephrology Physician 207RN0300X
- License
- 319395 (NY)
- Practice address
- 8900 Van Wyck Expy
Queens, NY 11418-3806 - Phone
- (718) 206-6000
- NPI assigned
- Mar 7, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nephrology
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Jamaica Hospital
Practice addresses (Care Compare)
13303 Jamaica Ave
Richmond Hill, NY 11418-2618
Phone (718) 291-3276
8900 Van Wyck Expy
Jamaica, NY 11418-2832
Phone (718) 206-6000
Hospital & facility affiliations
- Jamaica Hospital Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240730002135 | NY | Practitioner - Nephrology | 0547707309 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 319395 | NY | MD | Licensed Practical Nurse |
Practice roles (3 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jamaica Hospital | Current |
Accepting new patients | |
| Jamaica Hospital | Current |
Accepting new patients | |
| Jamaica Hospital Medical Center | Past | Accepting new patients |
Locations
80 Marcus Dr
Melville, NY 11747
Phone (631) 391-7889
13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942
8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
Interoperability endpoints
- mchang186797@direct.medisys.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 319395 | NY | Yes |
Addresses
Primary practice location
8900 Van Wyck Expy
Queens, NY 11418-3806
Mailing address
8900 Van Wyck Expy
Queens, NY 11418
Other providers in Queens, NY
- Caroline Home Care Services Inc
- Kymberlynn Carruthers
- Cda Medical
- Caycee Benigna Edem Centeno
- Fnu Chaithanya Avanthika
- Margaret Chau
- Jenny Chen
- Suzanna Mila Chen
- John Cherry
- Szeya Cheung
All providers in Queens, NY · Nephrology Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.