Individual provider Active NPI

Harvey Chung-Der Chang, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Modesto, CA
National Provider Identifier
1629074810
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
C50076 Issued in CA
Practice address
4301 N Star Way
Modesto, CA 95356-9262
Phone
(209) 577-1200
Fax
(209) 577-6517
NPI assigned
Jun 22, 2005
Last updated
Feb 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X C50076 CA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X C50076 CA Primary

Addresses

Primary practice location

4301 N Star Way
Modesto, CA 95356-9262

Mailing address

PO Box 576768
Modesto, CA 95357-6768
Phone (209) 577-1200

Other identifiers 3

IdentifierTypeStateIssuer
51897OtherMALICENSE
P00037347OtherCARAILROAD
C50076OtherCALICENSE

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040616001319 CA Practitioner - Pathology 8325022320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yosemite Pathology Medical Group IncGroup PAC ID 3072415751, 45 clinicians

Practice addresses (Care Compare)

4301 N Star Way
Suite a
Modesto, CA 95356-9262
Phone (209) 577-1200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.24 of 100Reported as individual
Quality
80.29
Improvement activities
0
Cost
75.48

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
50076CAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Yosemite Pathology Medical Group, Inc Cytopathology CurrentSince Feb 5, 1979 Accepting new patients
Yosemite Pathology Medical Group, in Past Accepting new patients

Locations

1205 E North St
Manteca, CA 95336
Phone (209) 239-8301

3172 Collins Dr
Ste B
Merced, CA 95348
Phone 2095771200220

1421 Oakdale Rd
Modesto, CA 95355
Phone (209) 572-0151

1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235

1700 Coffee Rd
Modesto, CA 95355
Phone (209) 526-4500

2625 Coffee Rd
Ste S
Modesto, CA 95355
Phone (208) 577-1200

4301 N Star Way
Modesto, CA 95356
Phone (915) 521-2290

4301 N Star Way
Ste A
Modesto, CA 95356

350 S Oak Ave
Oakdale, CA 95361
Phone (209) 847-3011

768 Mountain Ranch Rd
San Andreas, CA 95249
Phone (209) 464-6422

6001 Norris Canyon Rd
San Ramon, CA 94583
Phone (925) 275-8273

825 Delbon Ave
Turlock, CA 95382
Phone (209) 664-2744

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1629074810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 576768",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953576768",
            "telephone_number": "209-577-1200",
            "fax_number": "209-577-6517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 N STAR WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569262",
            "telephone_number": "209-577-1200",
            "fax_number": "209-577-6517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "HARVEY",
        "middle_name": "CHUNG-DER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "CA",
            "license": "C50076",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "C50076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "51897",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00037347",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "C50076",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.